Assessment of liver graft function and regeneration by galactosyl-human serum albumin (99mTc-GSA) liver scintigraphy in adult living-donor liver transplantation.
BACKGROUND
In adult living-donor liver transplantation (LDLT), the assessment of the graft functional reserve is very important. We evaluated the graft functional reserve by technetium-99m-diethylenetriaminepenta-acetic acid-galactosyl-human serum albumin ((99m)Tc-GSA) liver scintigraphy.


METHODS
From May 2003 to September 2006, (99m)Tc-GSA studies were performed in 27 adult recipients on two, four wk after LDLT, the receptor index [ratio of liver to heart-plus-liver radioactivity at 15 minutes (LHL15)] (LHL15) was calculated. Recipients were divided into two groups according to LHL15 on two wk after LDLT (group H; >0.935, group L; <0.935). Liver functional tests and recipients' background parameters were evaluated between the two groups.


RESULTS
Group L accompanied higher preoperative model for end-stage liver disease (MELD) score (p = 0.038), lower graft-recipient weight ratio (GRWR) (p = 0.032) and older donor age (p = 0.003) compared with group H. There was no significant difference in the graft regeneration rate between two groups. The three-yr cumulative survival rate was 76.1% in group L and 88.9% in group H.


CONCLUSIONS
In LDLT, LHL15 has the potential to assess the graft function and predict the recipients' outcome. Graft function after LDLT may be related closely to the pretransplant MELD score, GRWR, and donor age.
Iida
Taku
T
Division of Hepato-Biliary Pancreatic Surgery, Mie University, Tsu city, Mie, Japan. itaku@kuhp.kyoto-u.ac.jp
Isaji
Shuji
S
Yagi
Shintaro
S
Hori
Tomohide
T
Taniguchi
Kentaro
K
Ohsawa
Ichiro
I
Mizuno
Shugo
S
Usui
Masanobu
M
Sakurai
Hiroyuki
H
Yamagiwa
Kentaro
K
Yamakado
Kouichiro
K
Uemoto
Shinji
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006085:Graft Survival; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging*; D008111:Liver Function Tests; D008115:Liver Regeneration / Q000502:physiology*; D016031:Liver Transplantation / Q000502:physiology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015996:Survival Rate; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate; D015899:Tomography, Emission-Computed, Single-Photon; D055815:Young Adult
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C070561:technetium Tc 99m DTPA-galactosyl-human serum albumin; D016284:Technetium Tc 99m Pentetate