Korean J Med.  2005 Dec;69(6):622-630.

Risk factors of acute hepatic failure associated with transcatheter arterial chemoembolization for hepatocellular carcinoma

• Paik YH
• Chon CY
• Cho JY
• Ahn SH
• Lee KS
• Han KH
• Moon YM
• Lee DY
• Lee JT

Abstract

BACKGROUND: Transcatheter Arterial Chemoembolization (TACE) has been the most widely used treatment for advanced hepatocellular carcinoma (HCC) in Korea. However a number of complications associated with TACE have been reported in many studies. Acute hepatic failure is one of the most serious complications of TACE, because of its grave prognosis. The aim of this study was to investigate the risk factors associated with acute hepatic failure after TACE.
METHODS
A total of 263 TACE procedures performed in 163 patients with HCC were included in this study. We reviewed retrospectively the complications that occurred after TACE and analysed the risk factors associated with acute hepatic failure after TACE.
RESULTS
Complications included post-embolization syndrome (187 cases), temporary hepatic insufficiency (90 cases), acute hepatic failure (13 cases), hepatic arterial injury (9 cases), intrahepatic biloma (4 cases), liver infarction (2 cases), liver abscess (2 cases), tumor rupture (1 cases), gastrointestinal bleeding (14 cases), septicemia (3 cases), gall bladder infarction (2 cases), thrombocytopenia (2 cases), gastric perforation (1 cases), pneumonia (1 cases), urticaria (1 cases), sensorineural hearing loss (1 cases), femoral artery aneurysm (1 cases). According to univariate analysis, risk factors associated with acute hapatic failure after TACE were serum bilirubin and albumin, prothrombin time, dose of adriamycin, pre-TACE Child-Pugh class, tumor size, diffuse tumor type, portal vein thrombosis and TNM stage. Multivariate analysis revealed that serum bilirubin {odd ratio=3.86 (95% CI: 1.59-9.32)}, and diffuse tumor type {odd ratio=5.29 (95% CI: 1.46-23.86)} were statistically significant risk factors.
CONCLUSIONS
It is recommended that above mentioned risk factors should be considered carefully before TACE to prevent the occurrence of acute hepatic failure after TACE in HCC patients.

Keyword

Carcinoma; hepatocellular; Chemoembolization; therapeutic; Liver failure; acute; Complications

MeSH Terms

Aneurysm
Bilirubin
Carcinoma, Hepatocellular*
Doxorubicin
Femoral Artery
Hearing Loss, Sensorineural
Hemorrhage
Hepatic Insufficiency
Humans
Infarction
Korea
Liver
Liver Abscess
Liver Failure
Liver Failure, Acute*
Multivariate Analysis
Pneumonia
Prognosis
Prothrombin Time
Retrospective Studies
Risk Factors*
Rupture
Sepsis
Thrombocytopenia
Urinary Bladder
Urticaria
Venous Thrombosis
Bilirubin
Doxorubicin