A simple and accurate formula to estimate left hepatic graft volume in living-donor adult liver transplantation.
BACKGROUND
In the field of living-donor adult liver transplantation, a small-for-size graft often occurs, particularly when using left-lobe grafts. This is because of the limited volumes associated with left-lobe grafts. The accurate preoperative evaluation of graft volumes is crucial to avoid this complication. The aim of this study is to clarify the usefulness of a new formula to estimate the left-lobe graft volume.


METHODS
In 61 left-lobe grafts, a new formula was created with stepwise regression analysis using the following variables: height, weight, the thoracic and abdominal distance from anterior to posterior side (A-P), and distance from left to right side (L-R) of the initial 20 donors. With another 41 donors, the difference between the actual and estimated graft volume using the formula and two- and three-dimensional computed tomography was prospectively evaluated.


RESULTS
On the basis of the results of the stepwise regression analysis, a new formula was created as follows: graft volume (ml) = 313.4 + 7.7 x weight (kg)-12.6 x thoracic L-R (cm). The difference between the actual and estimated graft volumes using the formula was significantly better (10.8 +/- 9.5%) than that of the volumetry using two-dimensional computed tomography (16.3 +/- 10.1%) (P < 0.05).


CONCLUSIONS
In conclusion, the new formula can estimate the actual graft volume more accurately than conventional volumetry with two-dimensional computed tomography. The formula is useful to estimate the volume of left-lobe graft in living-donor adult liver transplantation.
Harada
Noboru
N
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. nharada@surg2.med.kyushu-u.ac.jp
Shimada
Mitsuo
M
Yoshizumi
Tomoharu
T
Suehiro
Taketoshi
T
Soejima
Yuji
Y
Maehara
Yoshihiko
Y
D000328:Adult; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008099:Liver / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic; D009929:Organ Size; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012044:Regression Analysis; D020858:Tissue and Organ Harvesting; D014057:Tomography, X-Ray Computed