New technologies for predicting liver failure in patients undergoing surgical resection of the liver

Extended surgical removal of malignant liver tumors results in improved survival of the majority of patients but is also associated with an increased risk of postoperative liver failure causing death in some patients. This project is devoted to developing a gold standard technique for predicting postoperative liver failure after liver resection. The technology involved centers around relating liver function to liver volume. The group I will be working with has developed a technique for measuring fractional liver volume and undertaking virtual liver resection using a 3-D computed model. Liver function will be measured by both established and new techniques and will be related to corresponding liver volume. A study will measure liver function and volume in patients with liver tumors undergoing liver resection before and after surgery. Liver function to volume ratio will be correlated with clinical measures of liver dysfunction and failure respectively. Another study will evaluate whether these techniques are able to detect relatively small changes in liver function and volume such as may result from liver volume enhancement by portal vein embolization or intra-operative pre-conditioning. Furthermore, the determination of liver function to volume ratio in patients with and without chronic liver failure who are not undergoing surgery will explore the usefulness of this technique across the whole spectrum of reduced liver function in chronic disease.The project will provide me with an unique experience of research novel techniques for the measurement of liver function in relation to volume. This may have the potential to improve the safety of liver surgery by predicting the risk of postoperative liver failure as well as to becoming a new tool for the evaluation of liver function and volume enhancing procedures.