Predicting dry weight in patients with ascites and liver cirrhosis using computed tomography imaging.
OBJECTIVE
In cirrhotic patients, ascites may increase weight and adversely impact liver transplant candidacy.


METHODS
In this study we used linear and volume measurements from abdominal CT imaging to estimate dry weight of transplant candidates using multivariable linear regressions. We reviewed 200 scans. For males there were 81, 26, and 41 scans with no/small, moderate, and large ascites, respectively, and 41, 6, and 5 scans of females with no/small/moderate, and large ascites respectively.


RESULTS
In males without ascites, subxiphoid subcutaneous fat volume had the strongest correlation with weight (r = 0.826); the best prediction utilized four variables including height, subcutaneous subxiphoid fat volume, and intraabdominal and subcutaneous umbilicus fat volumes (r = 0.923, r2 = 0.852, SEE = 15.15, p < 0.001). In females, subcutaneous fat volume above the umbilicus had the best correlation (r = 0.815); incorporating height and anterior subxiphoid fat thickness increased predictive accuracy (r = 0.892, r2 = 0.796, SEE = 15.37, p < 0.001). These regressions consistently under-predicted scale weight in patients with moderate and large ascites (5.92 +/- 25.50 pounds and 11.21 +/- 19.34 pounds in males, and 2.29 +/- 23.76 and 8.37 +/- 11.44 in females).


CONCLUSIONS
Equations to estimate patient weight regardless of ascites may offer a more accurate representation of size than scale weight in transplant candidates with ascites.
McHugh
Patrick P
PP
Transplant Section, Department of Surgery, University of Kentucky, 800 Rose Street, Lexington, KY 40536, USA. patrick.mchugh.md@gmail.com
Shah
Sheetal H
SH
Johnston
Thomas D
TD
Gedaly
Roberto
R
Ranjan
Dinesh
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D001201:Ascites / Q000473:pathology* / Q000601:surgery; D015992:Body Mass Index; D001835:Body Weight; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology* / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods*