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A critical appraisal of liver growth reporting in ALPPS

Michael Linecker and Henrik Petrowsky
Department / Institution: 
Swiss HPB and Transplant Center, University Hospital Zurich, Zurich, Zurich, Switzerland
Date Project Approved: 
Friday, 11 March, 2016
Project Status: 
Application / Abstract: 
Following the first reports of exceptional liver growth in ALPPS, a large variety of measures quantifying liver growth have been developed. The abundance of these growth measures, however, makes a comparison between centers difficult. Experiences from our ALPPS cohort hint at a particularly high variance of liver growth reporting per time. In contrast to common assumptions, liver growth after stage 1 indicates a non-linear time pattern. Definitive time points of volumetry before stage 2 are therefore key making kinetic growth rates comparable.
The aim of this study is to critically evaluate and improve liver growth reporting in ALPPS. Overall Goal: To give recommendations how to report appropriately growth kinetic in ALPPS in order to provide comparability of results on hypertrophy among different studies.
Liver growth characteristics will be divided in two broad categories: Static and Dynamic liver growth parameters. Static liver growth parameters reflect absolute or relative liver volumes at stage 1 and 2 as well as their change. Dynamic liver growth parameters, also known as kinetic growth curve, include volume changes calculated per day or per week. The analysis will be performed in 2 steps: 1.) Identifying static and dynamic liver growth parameters of ALPPS in the literature 2.) Creating a liver growth curve depending on the time of volumetry after stage 1 using the International ALPPS Registry.


University Hospital Zurich
Department of Surgery
Raemistrasse 100
8091 Zurich, Switzerland


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