Starlinger P, et al. - The present analysis was conducted to predict postoperative liver dysfunction based on blood-derived microRNA (miRNA) signatures. In the preoperative plasma of 21 patients with postoperative liver dysfunction (LD) after liver resection and 27 matched controls, 554 miRNAs were detected using next-generation sequencing as an unbiased systematic approach. It was found that a regression model of the two miRNA ratios 151a-5p to 192-5p and 122-5p to 151a-5p reliably predicted postoperative LD, severe morbidity, prolonged intensive care unit and hospital stay and even mortality before surgery with remarkable accuracy, thus outperforming established postoperative LD markers. The data showed the clinical usefulness of a new biomarker based on miRNA to support the selection of partial hepatectomy patients. Dynamic changes during recovery of liver function indicate a possible role in the individualized treatment of patients. The data could thus help to adapt surgical strategies to the patient's specific risk profile.