title: Early regeneration of the remnant liver volume after right hepatectomy for living donation: a multiple regression analysis.
abstract: Early liver regeneration was studied in a series of 70 patients who underwent right hepatectomy for living donation between November 2004 and January 2010. Liver regeneration was evaluated with multidetector computed tomography (MDCT) at a mean of 61.07 days after surgery. Presurgical variables [eg, age, weight, height, body mass index (BMI), liver function tests, creatinine levels, platelet counts, international normalized ratio, and glucose levels] and variables detected with preoperative MDCT imaging [eg, main portal vein diameter, steatosis, original liver volume, and spleen volume (SV)] were investigated as potential predictors of liver regeneration. The future remnant liver volume (FRLV) was preoperatively calculated with a virtual surgical cut. Liver function tests and creatinine levels were recorded on the 30th postoperative day. In addition, the onset of postoperative complications occurring within 90 days of surgery was analyzed, and the complications were codified according to the 5 tiers of the Clavien-Dindo classification. In 26 of the 70 patients (37.14%), 100% or greater hepatic regeneration had occurred at 2 months. There was no association between the clinical outcome and the liver regeneration rate. A stepwise multiple regression analysis showed that a higher BMI (coefficient = 0.035, P < 0.0001) and preoperative parameters such as a smaller FRLV (coefficient = -0.002, P < 0.0001) and a greater SV/FRLV ratio (coefficient = 1.196, P < 0.0001) were predictors of greater liver regeneration.
authors.affiliation: Mediterranean Institute for Transplantation and Advanced Specialized Therapies, University of Pittsburgh Medical Center, Palermo, Italy. sgruttadauria@ismett.edu
authors.forename: Salvatore
authors.initials: S
authors.lastname: Gruttadauria
authors.forename: Vishal
authors.initials: V
authors.lastname: Parikh
authors.forename: Duilio
authors.initials: D
authors.lastname: Pagano
authors.forename: Fabio
authors.initials: F
authors.lastname: Tuzzolino
authors.forename: Davide
authors.initials: D
authors.lastname: Cintorino
authors.forename: Roberto
authors.initials: R
authors.lastname: Miraglia
authors.forename: Marco
authors.initials: M
authors.lastname: Spada
authors.forename: Giovanbattista
authors.initials: G
authors.lastname: Vizzini
authors.forename: Angelo
authors.initials: A
authors.lastname: Luca
authors.forename: Bruno
authors.initials: B
authors.lastname: Gridelli
mesh_terms: D000328:Adult; D015992:Body Mass Index; D016208:Databases, Factual; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008099:Liver / Q000502:physiology*; D008107:Liver Diseases / Q000601:surgery / Q000628:therapy; D008111:Liver Function Tests; D008115:Liver Regeneration; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods; D012044:Regression Analysis; D012189:Retrospective Studies; D016896:Treatment Outcome