Liver · LIVE

Liver decompensation after HCC resection

HCC-LD

Apply the Citterio 2016 JAMA Surgery hierarchic three-class rule to caller-assigned portal hypertension, planned major hepatectomy, and MELD, and return risk low, intermediate, or high with the published liver-decompensation and liver-related mortality percents.

LIVE $0.005 USDC GET /api/calc/hcc_ld

Markdown: /docs/hcc-ld.md · Canonical: https://magentlab.com/docs/hcc-ld

Not a medical device. Not a diagnosis, dose, or listing recommendation.

What it computes

Apply the Citterio 2016 JAMA Surgery hierarchic three-class rule to caller-assigned portal hypertension, planned major hepatectomy, and MELD, and return risk low, intermediate, or high with the published liver-decompensation and liver-related mortality percents.

When to use

When an agent already has caller-assigned portal hypertension, planned resection extent, and a MELD score, and needs the published Citterio 2016 HCC-resection decompensation class. magent does not compute MELD or HVPG.

When not to use

• Not a medical device and not a diagnosis of hepatocellular carcinoma or liver decompensation.
• Not a surgical indication and not a transplant listing protocol.
• Citterio 2016 JAMA Surgery published classes only. High is portal hypertension plus major hepatectomy. Low is no portal hypertension, minor resection, and MELD ≤ 9. All other combinations are intermediate.
• portal_hypertension, major_hepatectomy, and meld are caller-assigned. magent does not measure HVPG, choose extent of resection, or compute MELD.
• Not ALBI. This tool does not implement Johnson 2015 albumin-bilirubin grade.

Formula

Citterio 2016 JAMA Surgery: high if portal_hypertension and major_hepatectomy; low if not portal_hypertension and not major_hepatectomy and meld ≤ 9; else intermediate. Published LD 4.9 / 28.6 / 60.0 and liver-related mortality 4.4 / 9.0 / 25.0. Caller-assigned PHT, planned extent, and MELD. magent does not compute MELD or HVPG.

Citation

Title

Hierarchic Interaction of Factors Associated With Liver Decompensation After Resection for Hepatocellular Carcinoma

Authors

Citterio D, Facciorusso A, Sposito C, Rota R, Bhoori S, Mazzaferro V

Source

JAMA Surg. 2016;151(9):846-853

DOI

10.1001/jamasurg.2016.1121

Worked example

Also searched as

• Citterio HCC-LD
• liver decompensation after HCC resection
• HCC resection decompensation
• Citterio 2016
• post-hepatectomy liver decompensation
• hepatocellular carcinoma resection risk
• Citterio JAMA Surgery

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/hcc_ld?portal_hypertension=false&major_hepatectomy=false&meld=8

Full URL: https://api.magentlab.com/api/calc/hcc_ld?portal_hypertension=false&major_hepatectomy=false&meld=8

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge.

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/hcc_ld?portal_hypertension=false&major_hepatectomy=false&meld=8"

Parameters

Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

POST /api/calc/hcc_ld Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 PREVIEW

• 1 to 25 items. Each item uses the same keys as the GET query parameters.
• POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
• The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
• HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
• Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
• x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request (fixture)

{
  "items": [
    {
      "major_hepatectomy": "false",
      "meld": "8",
      "portal_hypertension": "false"
    },
    {
      "major_hepatectomy": "false",
      "meld": "8",
      "portal_hypertension": "false"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/hcc_ld",
  "items": [
    {
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Citterio D, Facciorusso A, Sposito C, Rota R, Bhoori S, Mazzaferro V",
        "doi": "10.1001/jamasurg.2016.1121",
        "id": "citterio-2016",
        "pmid": "27248425",
        "source": "JAMA Surg. 2016;151(9):846-853",
        "title": "Hierarchic Interaction of Factors Associated With Liver Decompensation After Resection for Hepatocellular Carcinoma"
      },
      "formula": "hcc_ld",
      "formula_expression": "Citterio 2016 JAMA Surgery: high if portal_hypertension and major_hepatectomy; low if not portal_hypertension and not major_hepatectomy and meld ≤ 9; else intermediate. Published LD 4.9 / 28.6 / 60.0 and liver-related mortality 4.4 / 9.0 / 25.0. Caller-assigned PHT, planned extent, and MELD. magent does not compute MELD or HVPG.",
      "criteria": [
        {
          "factor": "portal_hypertension",
          "met": false
        },
        {
          "factor": "major_hepatectomy",
          "met": false
        },
        {
          "value": 8,
          "factor": "meld_le_9",
          "met": true
        },
        {
          "factor": "low",
          "met": true
        },
        {
          "factor": "intermediate",
          "met": false
        },
        {
          "factor": "high",
          "met": false
        }
      ],
      "risk": "low",
      "ld_rate_percent": 4.9,
      "liver_related_mortality_percent": 4.4,
      "major_hepatectomy": false,
      "meld": 8,
      "portal_hypertension": false
    },
    {
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Citterio D, Facciorusso A, Sposito C, Rota R, Bhoori S, Mazzaferro V",
        "doi": "10.1001/jamasurg.2016.1121",
        "id": "citterio-2016",
        "pmid": "27248425",
        "source": "JAMA Surg. 2016;151(9):846-853",
        "title": "Hierarchic Interaction of Factors Associated With Liver Decompensation After Resection for Hepatocellular Carcinoma"
      },
      "formula": "hcc_ld",
      "formula_expression": "Citterio 2016 JAMA Surgery: high if portal_hypertension and major_hepatectomy; low if not portal_hypertension and not major_hepatectomy and meld ≤ 9; else intermediate. Published LD 4.9 / 28.6 / 60.0 and liver-related mortality 4.4 / 9.0 / 25.0. Caller-assigned PHT, planned extent, and MELD. magent does not compute MELD or HVPG.",
      "criteria": [
        {
          "factor": "portal_hypertension",
          "met": false
        },
        {
          "factor": "major_hepatectomy",
          "met": false
        },
        {
          "value": 8,
          "factor": "meld_le_9",
          "met": true
        },
        {
          "factor": "low",
          "met": true
        },
        {
          "factor": "intermediate",
          "met": false
        },
        {
          "factor": "high",
          "met": false
        }
      ],
      "risk": "low",
      "ld_rate_percent": 4.9,
      "liver_related_mortality_percent": 4.4,
      "major_hepatectomy": false,
      "meld": 8,
      "portal_hypertension": false
    }
  ]
}

Response

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup.

{
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Citterio D, Facciorusso A, Sposito C, Rota R, Bhoori S, Mazzaferro V",
    "doi": "10.1001/jamasurg.2016.1121",
    "id": "citterio-2016",
    "pmid": "27248425",
    "source": "JAMA Surg. 2016;151(9):846-853",
    "title": "Hierarchic Interaction of Factors Associated With Liver Decompensation After Resection for Hepatocellular Carcinoma"
  },
  "formula": "hcc_ld",
  "formula_expression": "Citterio 2016 JAMA Surgery: high if portal_hypertension and major_hepatectomy; low if not portal_hypertension and not major_hepatectomy and meld ≤ 9; else intermediate. Published LD 4.9 / 28.6 / 60.0 and liver-related mortality 4.4 / 9.0 / 25.0. Caller-assigned PHT, planned extent, and MELD. magent does not compute MELD or HVPG.",
  "criteria": [
    {
      "factor": "portal_hypertension",
      "met": false
    },
    {
      "factor": "major_hepatectomy",
      "met": false
    },
    {
      "value": 8,
      "factor": "meld_le_9",
      "met": true
    },
    {
      "factor": "low",
      "met": true
    },
    {
      "factor": "intermediate",
      "met": false
    },
    {
      "factor": "high",
      "met": false
    }
  ],
  "risk": "low",
  "ld_rate_percent": 4.9,
  "liver_related_mortality_percent": 4.4,
  "major_hepatectomy": false,
  "meld": 8,
  "portal_hypertension": false
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

Related tools

• MELD — Compute the Kamath 2001 model for end-stage liver disease (MELD) integer from creatinine, bilirubin, INR, and cholestatic or alcoholic etiology.
• Child–Pugh — Compute the Child–Turcotte–Pugh cirrhosis severity score from bilirubin, albumin, INR, encephalopathy, and ascites.

Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /docs/mcp.

Guarantees

• HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
• exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
• HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
• Execution is timeout-bounded and concurrency-capped.
• Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.