Effect Of Preoperative HBV-DNA Loading On Liver Function Failure After Hepatocellular Carcinoma Resection

Objective:To explore the impact of preoperative HBV-DNA loading on posthepatectomy liver failure (PHLF) following liver resection for hepatocellular carcinoma (HCC).Methods:Retrospective analysis of 342 patients of Hepatitis B related HCC undergoing liver resection with Child-Pugh A level before the operation. Compare the effect of different HBV-DNA loading levels on the recurrence of liver failure post-operation and use univariate and multivariate method to assess the effect of HBV-DNA loading levels on PHLF according to the international society for liver surgery on postoperative liver failure criteria.we also tested the ICG in 103 cases of Hepatitis B related HCC patients, correlations between HBV-DNA loading levels on Hepatitis B related HCC and the liver function.Results:1.99 of 342 patients developed PHLF(29.0%), including grade A 45 cases (13.2%), grade B 53 cases (15.5%), grade C level 1 case (0.3%), no dead patients were reported.2. Group HBeAg(+)HBeAb(-)compared with group HBeAg(-)HBeAb(+) and group HBeAg(-)HBeAb(-) respectively, preoperative HBV-DNA loading levels difference showed statistical significance(P<0.05); group HBeAg(-)HBeAb(+) compared with group HBeAg(-)HBeAb(-) preoperative HBV-DNA loading levelsshowed no significant statistical difference(P>0.05), PHLF-B level and above comparative differences also showed no statistical significance (x2=1.923, P=1.923).3. According to preoperative HBV-DNA loading levels, PHLF-B with rate more than 13.5%(14/104) in the negative group,103IU/mL group 10.7%(6/56), 104IU/mL group19.0%(12/63),105IU/mL group16.7%(12/72) and≥106 IU/mL 21.3%(10/47), showed no statistical significance (P>0.05).4. Antiviral and antiviral group PHLF-B level and above rate comparison difference didn’t show statistical significance (x2=0.640, P=0.640).5. Univarite logistic regression analysis showed a wide range of resection, intraoperative blood loss>800ml,platelet<100×109/L, ALB<35g/L, PA< 170mg/L, AST<40U/L, ALT<40U/L and cirrhosis were the risk factors affecting PHLF-B and above; Preoperative HBV DNA positive loading levels were not a risk factor for PHLF-B and above happen.6. Multivariable logistic regression analysis found that a wide range of resection, intraoperative blood loss> 800ml, platelet<100×109/L, albumin<35g/L, liver cirrhosis were independent predictors of PHLF-B level and above; However, Preoperative HBV-DNA loading levels positive was not an independent predictor of PHLF-B level and above.7. Preoperative HBV-DNA loading levels ICGR5min, ICGR10min, ICGR15min difference is compared between group and no significant difference was detected (P>0.05); Compare ICGR15min level no obvious statistical significance difference (P>0.05).Conclusions:For preoperative liver function Child-Pugh grade A with resectable HCC patients, due to high HBV-DNA loading levelsshowed no impact on liver function reserves, and high preoperative HBV-DNA loading levelswas not an independent predictor of PHLF-B level and above, no special treatment to clinical treatment. So for preoperative Child-Pugh grade A for resectable HCC patients preoperative after short-term antiviral treatment, early surgery should be encouraged.