title: Using on-site liver 3-D reconstruction and volumetric calculations in split liver transplantation.
abstract: BACKGROUND
  Split liver transplantation increases the number of grafts available for transplantation. Pre-recovery assessment of liver graft volume is essential for selecting suitable recipients. The purpose of this study was to determine the ability and feasibility of constructing a 3-D model to aid in surgical planning and to predict graft weight prior to an in situ division of the donor liver.
  
  
  METHODS
  Over 11 months, 3-D volumetric reconstruction of 4 deceased donors was performed using Pathfinder Scout© liver volumetric software. Demographic, laboratory, operative, perioperative and survival data for these patients along with donor demographic data were collected prospectively and analyzed retrospectively.
  
  
  RESULTS
  The average predicted weight of the grafts from the adult donors obtained from an in situ split procedure were 1130 g (930-1458 g) for the extended right lobe donors and 312 g (222-396 g) for left lateral segment grafts. Actual adult graft weight was 92% of the predicted weight for both the extended right grafts and the left lateral segment grafts. The predicted and actual graft weights for the pediatric donors were 176 g and 210 g for the left lateral segment grafts and 308 g and 280 g for the extended right lobe grafts, respectively. All grafts were transplanted except for the right lobe from the pediatric donors due to the small graft weight.
  
  
  CONCLUSIONS
  On-site volumetric assessment of donors provides useful information for the planning of an in situ split and for selection of recipients. This information may expand the donor pool to recipients previously felt to be unsuitable due to donor and/or recipient weight.
authors.affiliation: Ochsner Multi-Organ Transplant Institute, Ochsner Medical Center, 1514 Jefferson Highway, New Orleans, LA 70121, USA. trevor.reichman@vcuhealth.org.
authors.forename: Trevor W
authors.initials: TW
authors.lastname: Reichman
authors.forename: Brittany
authors.initials: B
authors.lastname: Fiorello
authors.forename: Ian
authors.initials: I
authors.lastname: Carmody
authors.forename: Humberto
authors.initials: H
authors.lastname: Bohorquez
authors.forename: Ari
authors.initials: A
authors.lastname: Cohen
authors.forename: John
authors.initials: J
authors.lastname: Seal
authors.forename: David
authors.initials: D
authors.lastname: Bruce
authors.forename: George E
authors.initials: GE
authors.lastname: Loss
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003661:Decision Support Techniques; D046148:Donor Selection; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008099:Liver / Q000033:anatomy & histology* / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D066230:Patient-Specific Modeling; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D012189:Retrospective Studies; D012984:Software; D014019:Tissue Donors / Q000600:supply & distribution*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult