title: Modified Hepatic Venous Plane: A Key Factor for Improving Preoperative MDCT Donor Volume Prediction in Living-Donor Liver Transplantation.
abstract: OBJECTIVE
  The aim of this work was to present our experience using a modified hepatic venous plane in multidetector computerized tomography (MDCT) for reducing the discrepancy between preoperative liver volume estimation and intraoperative weight (IOW) measurement in living-donor liver transplantation (LDLT).
  
  
  METHODS
  We retrospectively reviewed the medical records of 57 consecutive living donors with the use of MDCT as a modality for volumetric assessment for LDLT from May 2007 to January 2015. We divided living donors into 2 groups according to surgical methods: right hepatectomy (RH) and left hepatectomy (LH). Initial liver volumetric measurement (group I) was assessed. After discussions with radiologist, the transplantation surgeon used a modified hepatic venous plane for surgical significant middle hepatic venous variants (>5 mm) in 16 living donors and applied the initial surgical plane in the remaining for the modified donor liver volumetric measurement (group II). We then compared the correlations of these 2 groups with the use of IOW.
  
  
  RESULTS
  The overall correlation (r) between group I and IOW was 0.947. The correlations (r) between group I and IOW were 0.872 and 0.955 for RH and LH, respectively. Compared with group I, group II showed better correlation with IOW: r = 0.949 and 0.981 for RH and LH, respectively. The overall correlation (r) between group II and IOW was 0.980, and the error ratio was 5.95 ± 5.05%.
  
  
  CONCLUSIONS
  Our study showed that using a modified hepatic venous plane in preoperative MDCT, after good communication between transplant surgeon and radiologist, can provide more accurate liver volume estimation and achieve a better correlation with IOW in LDLT.
authors: Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors: M-C
authors: MC
authors: Liu
authors: Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors: Y-T
authors: YT
authors: Lin
authors: Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Surgery, Chung Shan Medical University, Taichung, Taiwan.
authors: S-B
authors: SB
authors: Cheng
authors: Department of Veterinary Medicine, National Chung Hsing University, Taichung City, Taiwan; School of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan. Electronic address: swhtcvgh@gmail.com.
authors: S-W
authors: SW
authors: Hung
authors: Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.
authors: C-Y
authors: CY
authors: Lai
authors: Department of Radiology, E-Da Hospital and I-Shou University, Kaohsiung, Taiwan; Center for Functional Onco-imaging, University of California, Irvine, California, USA.
authors: J-H
authors: JH
authors: Chen
authors: Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Radiologic Technology and Graduate Institute of Radiologic Science, Central Taiwan University of Science and Technology, Taichung, Taiwan; Department of Physical Therapy, Hungkuang University of Technology, Taichung, Taiwan; Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan.
authors: C C-C
authors: CC
authors: Chen
mesh_terms: D000328:Adult; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006503:Hepatic Veins / Q000601:surgery; D006801:Humans; D008099:Liver / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D012189:Retrospective Studies; D020858:Tissue and Organ Harvesting / Q000379:methods*