Factors associated with outcome of liver surgery and hepatocellular carcinoma

Chronic liver disease resulting in fibrosis and cirrhosis is associated with morbidity and mortality, irrespective of the etiology. Although major progress has been made in the medical management of patients with liver diseases, liver surgery remains the only curative treatment strategy for many conditions. Yet, factors such as perioperative bleeding, and the capacity of remnant liver to regenerate may affect the outcome following the liver surgery. In this thesis we conducted clinical and pre-clinical studies that aimed to gain better understanding of factors influencing the outcome of liver surgery. In addition, we evaluate if the development of HCC in patients with cirrhosis is associated with activation of primary hemostasis and whether or not the bioactive molecules within the platelets are altered in cirrhotic patients with hepatocellular carcinoma (HCC). In addition, we studied the paradoxical relation of gamma glutamyl-transferase (GGT) with outcome in liver transplantation patients and in patients admitted to the intensive care unit.