Ratio of remnant to total liver volume or remnant to body weight: which one is more predictive on donor outcomes?
BACKGROUND
Right lobe donations are known to expose the donors to more surgical risks than left lobe donations. In the present study, the effects of remnant volume on donor outcomes after right lobe living donor hepatectomies were investigated.


METHODS
The data on 262 consecutive living liver donors who had undergone a right hepatectomy from January 2004 to June 2011 were retrospectively analysed. The influence of the remnant on the outcomes was investigated according to the two different definitions. These were: (i) the ratio of the remnant liver volume to total liver volume (RLV/TLV) and (ii) the remnant liver volume to donor body weight ratio (RLV/BWR). For RLV/TLV, the effects of having a percentage of 30% or below and for RLV/BWR, the effects of values lower than 0.6 on the results were investigated.


RESULTS
Complication and major complication rates were 44.7% and 13.2% for donors with RLV/TLV of ≤30%, and 35.9% and 9.4% for donors with RLV/BWR of < 0.6, respectively. In donors with RLV/TLV of ≤30%, RLV/BWR being below or above 0.6 did not influence the results in terms of liver function tests, complications and hospital stay. The main impact on the outcome was posed by RLV/TLV of ≤30%.


CONCLUSIONS
Remnant volume in a right lobe living donor hepatectomy has adverse effects on donor outcomes when RLV/TLV is ≤30% independent from the rate of RLV/BWR with a cut-off point of 0.6.
Florence Nightingale Hospital, Organ Transplant Center, Istanbul, Turkey. onuryaprak@hotmail.com
Onur
O
Yaprak
Necdet
N
Guler
Gulum
G
Altaca
Murat
M
Dayangac
Tolga
T
Demirbas
Murat
M
Akyildiz
Levent
L
Ulusoy
Yaman
Y
Tokat
Yildiray
Y
Yuzer
D000328:Adult; D000704:Analysis of Variance; D001835:Body Weight; D016009:Chi-Square Distribution; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009929:Organ Size; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D014421:Turkey