Preoperative volume prediction in adult live donor liver transplantation: 3-D CT volumetry approach to prevent miscalculations.
BACKGROUND
The precise preoperative calculation of functional liver volumes for both donor and recipient is a crucial part of the evaluation process in adult living donor liver transplantation. The purpose of this study was to describe and validate our modus 3-D CT volumetry.


METHODS
Native (unenhanced), arterial, and venous phase CT images from 62 consecutive live liver donors were subjected to 3-D CT liver volume calculations and virtual 3-D liver partitioning. Graft-volume estimates based on our modus 3-D volumetry, which subtracted intrahepatic vascular volume from the "smallest" (native) unenhanced CT phase, were subsequently compared to the intraoperative graft-weights obtained in all 62 cases. Calculated (preoperative) liver-volume-body-weight-ratios and measured (intraoperative) liver-weight-body-weight-ratios of liver grafts were analyzed.


RESULTS
Preoperative calculations of graft-volume according to our modus 3-D CT volumetry did not yield statistically significant over- or under-estimations when compared to the intraoperative findings independent of their age or gender.


CONCLUSIONS
Our modus 3-D volumetry, when based on the "smallest" (native) unenhanced CT phase, accurately accounted for intrahepatic vascular volumes and offered a precise virtual model of individualized operative conditions for each potential live liver donor.
Radtke
A
A
Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany.
Sotiropoulos
G C
GC
Nadalin
S
S
Molmenti
E P
EP
Schroeder
T
T
Saner
F H
FH
Sgourakis
G
G
Cicinnati
V R
VR
Valentin-Gamazo
C
C
Broelsch
C E
CE
Malago
M
M
Lang
Hauke
H
D000328:Adult; D000465:Algorithms; D001706:Biopsy; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008099:Liver / Q000000981:diagnostic imaging* / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D020858:Tissue and Organ Harvesting / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014463:Ultrasonography