Introduction : Post-hepatectomy liver failure (PHLF) is a critical, unmet need in the surgical treatment of liver diseases. A comprehensive lipidomic analysis was conducted to identify potential lipid signatures that can be used for early prediction of PHLF by examining the serum lipid profiles of pigs undergoing sham operation, 70% and 90% partial hepatectomy (PH).

Methods : Time-dependent changes in individual lipid levels were investigated using sera collected at pre-operation (PO), 14 h, 30 h, and 48 h after PH using nanoflow ultrahigh performance liquid chromatography-electrospray ionization-tandem mass spectrometry.

Results : Of the 184 quantified lipids, 9 lipids showed significant differences (> 2-fold and P < 0.01) between the 70% PH and 90% PH groups at 30 h after the operation. The four phosphatidylcholine plasmalogen (PCp) (p-16:0/16:0, p-18:0/18:2, p-18:0/20:4, and p-18:0/22:6) continuously increased by several folds in the 90% PH group while these returned to PO levels after 30 h in the 70% PH group, presumably implying the failure markers. On the other hand, triacylglycerol (TG) showed an opposite trend, wherein five TGs (40:0, 42:0, 44:1, 44:2, and 48:3) in the 90% PH group showed continuous decrease while these in the 70% PH group were abruptly increased by 3~6 folds until 30 h but decreased at 48 h, implying the recovery markers.

Conclusions : Receiver operating characteristic analysis and Pearson correlation coefficients of the lipid levels in combination with total bilirubin and prothrombin time showed that the above four PCps can be utilized as potential signatures to differentiate the early stage of PHLF.