The impact of 3-D virtual hepatectomy simulation in living-donor liver transplantation.
OBJECTIVE
In living-donor liver transplantation, accurate assessments of liver graft volume and anatomical variation are mandatory for the preoperative planning of safe donor hepatectomy and successful recipient implantation. The aim of this study was to assess the feasibility and accuracy of novel three-dimensional (3-D) virtual hepatectomy simulation software in living-donor liver transplantation.


METHODS
We developed the hepatectomy simulation software, which was programmed to analyze detailed 3-D vascular structure and to predict liver graft volume, based on hepatic circulation.


RESULTS
In 101 individuals, including 4 living donors, the predicted liver resection volumes revealed a significant correlation with the actual value (P < 0.0001), with a mean difference of 7.9 ml. The drainage area by the individual hepatic vein branch was quantified to achieve reconstruction of the corresponding venous branch. The application of multidetector computed technology scanning and virtual cholangioscopy facilitated more detailed visualization of the 3-D hilar anatomy in a left trisectoral graft transplantation.


CONCLUSIONS
This hepatectomy simulation software reliably predicted accurate liver graft volume and the drainage volume of hepatic vein branches. This software may contribute to the preoperative planning of safe donor hepatectomy and implantation with satisfactory graft viability.
Yamanaka
Junichi
J
First Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
Saito
Shinichi
S
Iimuro
Yuji
Y
Hirano
Tadamichi
T
Okada
Toshihiro
T
Kuroda
Nobukazu
N
Sugimoto
Takaaki
T
Fujimoto
Jiro
J
D005260:Female; D006498:Hepatectomy; D006503:Hepatic Veins; D006801:Humans; D021621:Imaging, Three-Dimensional; D008099:Liver / Q000098:blood supply; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D012984:Software; D014584:User-Computer Interface