A correlation between the graft volume evaluation and the prognosis in consideration of hepatic "compliance" in living donor liver transplantation.
OBJECTIVE
The aim is to clarify the correlation between the hepatic compliance and prognosis of the patients who underwent LDLT.


METHODS
Volumetry was performed using a 3D volume analyzer. The hepatic compliance was evaluated based on the difference between the estimated total liver volume in the arterial phase and venous phase (n=66). The correlations among the hepatic compliance, donor background factors and the recipient's prognosis were evaluated.


RESULTS
Fourteen cases (21%) presented with a more than 5% increase in volume during the venous phase than in the arterial phase, and 12 of these recipients were still alive. There was a significant increase in death among recipients from donors age 60 years old and older (5/7, 71.4%, p<0.01). In these cases, the hepatic compliance was significantly different between the deceased cases and the surviving cases; while there was no hepatic compliance in the five deceased cases, favorable hepatic compliance was observed in two of the surviving cases (p<0.01).


CONCLUSIONS
Hepatic compliance appears to exist. The poor prognosis of liver grafts in recipients from elderly donors may be attributable to hepatic compliance, and assessing the hepatic compliance may be useful for preoperative liver graft evaluation.
Akihiko
A
Soyama
Mitsuhisa
M
Takatsuki
Izumi
I
Yamaguchi
Masaaki
M
Hidaka
Koji
K
Natsuda
Ayaka
A
Kinoshita
Tomohiko
T
Adachi
Amane
A
Kitasato
Zhassulan
Z
Baimakhanov
Tamotsu
T
Kuroki
Susumu
S
Eguchi
D000328:Adult; D000367:Age Factors; D000368:Aged; D003187:Compliance; D046148:Donor Selection; D005260:Female; D006498:Hepatectomy; D006801:Humans; D021621:Imaging, Three-Dimensional; D008099:Liver / Q000000981:diagnostic imaging* / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult