CD4+CD25+ regulatory T cells decreased future liver remnant after associating liver partition and portal vein ligation for staged hepatectomy

Table 1 Baseline index data of hepatocellular carcinoma patients undergoing association liver partition and portal vein ligation for staged hepatectomy

Variable	ALPPS, n = 37
Age, yr	45 (26-75)
Sex, women/man, n (%)	3 (8.1)/34 (91.9)
BMI, kg/m2	22.2 (17.99-30.09)
AFP, ≥ 400 ng/mL/< 400 ng/mL, n (%)	19 (51.4)/18 (48.6)
Degree of liver fibrosis, n
No fibrosis	7
Mild fibrosis	2
Moderate fibrosis/fibrosis	8
Cirrhosis, n (%)	20 (54.1)
MELD score	5.12 (0.75-11.00)
ICGR15, %	5.3 (1.3-18.8)
Child-Pugh class, A/B/C, n	36/1/0
BCLC staging, A/B/C, n	10/7/20

AFP: Alpha-fetoprotein; ALPPS: Association liver partition and portal vein ligation for staged hepatectomy; BCLC: Barcelona Clinic Liver Cancer; BMI: Body mass index; ICGR15: Indocyanine green retention rate at 15 min; MELD: Model for end-stage liver disease.

Table 2 Intraoperative and postoperative conditions of association liver partition and portal vein ligation for staged hepatectomy - stage 1 and 2

Variable	ALPPS - stage 1	ALPPS - stage 2
Operative time, min	341 (229-496)	300 (167-483)
Blood loss, mL	328 (50-2600)	792 (200-6000)
Blood transfusion, mL	300 (0-900)	250 (0-2150)
Postoperative bile leakage, n
No	36	27
Yes	1	3
Clavien-Dindo classification, n
I	20	12
II	14	14
III	3	4
IV	0	0
ISGLS classification, n
A	21	9
B	16	18
C	0	1
Ishak fibrosis score	/	3 (1-6)
Ishak inflammation score	/	5 (2-12)

ALPPS: Association liver partition and portal vein ligation for staged hepatectomy; ISGLS: International Study Group of Liver Surgery.

Table 3 The proportion of CD4⁺CD25⁺ regulatory T cells to CD4⁺ T cells before and after the association liver partition and portal vein ligation for staged hepatectomy - stage 1 and 2

ALPPS	PRE	POD1	POD3	POD5	POD7	POD10	F	P value
ALPPS-1	1.69 ± 1.32	1.79 ± 1.42	2.29 ± 1.34	2.41 ± 1.49	2.62 ± 1.72	2.64 ± 1.64	6.962	0.001
ALPPS-2	1.69 ± 1.32	2.19 ± 1.26	2.28 ± 1.63	2.73 ± 2.05	2.21 ± 1.49	2.34 ± 1.35	4.726	0.011

ALPPS: Association liver partition and portal vein ligation for staged hepatectomy; POD: Postoperative day; PRE: Preoperative.

Table 4 Data related to liver volume, including standard liver volume, future liver remnant, future liver remnant/standard liver volume ratio, and future liver remnant increase

Variable	ALPPS stage 1 and 2
SLV, cm3	1034.0 (851.9-1300.7)
Preoperation of ALPPS-1
FLR, cm3	1043.3 (851.8-1358.2)
FLR/SLV, %	35.1 (18.9-47.4)
Preoperation of ALPPS-2
FLR, cm3	548.4 (378.1-823.0)
FLR/SLV, %	53.2 (33.8-78.3)

ALPPS: Association liver partition and portal vein ligation for staged hepatectomy; FLR: Future liver remnant; SLV: Standard liver volume.