title: Difference of regeneration potential between healthy and diseased liver.
abstract: BACKGROUND
  We sought to evaluate total and segmental liver regeneration by comparing preoperative computed tomographic (CT) volumetry and CT volumetry on postoperative day (POD) 7 after a right hepatectomy, in patients with various status and surgical indications.
  
  
  METHODS
  We included 36 patients who underwent right lobectomy for living donor liver transplantation (healthy group), and 29 for hepatocellular carcinoma treatment (disease group). All of the disease group patients were Child-Turcotte-Pugh (CTP) class A. The regeneration of lateral, medial segment and total remnant liver volumes were assessed on POD 7 using a CT-based program. Total volumes and segmental volumes were measured for total liver, future liver remnant (FLR), and liver remnant. We calculated total and segmental early regeneration indexes, defined as [(VLR-VFLR)/VFLR]×100, where VLR is volume of the liver remnant and VFLR is volume of the FLR.
  
  
  RESULTS
  The VLR at POD 7 showed a 72.9% increase in volume among the healthy versus 55% in the disease group, (P=.012) In the disease group, segmental volume and regeneration indexes were also significantly lower than among the healthy group: 59.0% versus 46.9% in the medial and 86.8% versus 57.7% in the lateral segment (P=.023 and P<.001) respectively.
  
  
  CONCLUSIONS
  The volume regeneration potential in diseased livers is significantly lower than that of a normal, healthy liver. So, we must consider a patient's liver status and volume profile before an extensive liver.
authors.affiliation: Department of Surgery, Yonsei University Health System, Gangnam Severance Hospital, Seoul, South Korea.
authors.forename: M K
authors.initials: MK
authors.lastname: Ju
authors.forename: G H
authors.initials: GH
authors.lastname: Choi
authors.forename: J S
authors.initials: JS
authors.lastname: Park
authors.forename: D S
authors.initials: DS
authors.lastname: Yoon
authors.forename: J
authors.initials: J
authors.lastname: Choi
authors.forename: M S
authors.initials: MS
authors.lastname: Kim
authors.forename: S I
authors.initials: SI
authors.lastname: Kim
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008115:Liver Regeneration; D016031:Liver Transplantation; D019520:Living Donors; D009929:Organ Size; D056910:Republic of Korea; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome