Factors Affecting Disparity Between Estimated Liver Volume and Actual Liver Volume in Living Donor Liver Transplantation.

Background

Volumetric evaluation is critical in living donor liver transplantation. Liver volume, depending on body weight and height, and radiological estimates have made important contributions, but some inconsistencies remain. We aimed to assess the estimated and radiological liver volumes with respect to actual graft weight and potential factors contributing to inaccuracy. Method: A total of 623 donors were evaluated in this retrospective study. The estimated liver volumes were calculated with the Vauthey formula. The laboratory and liver biopsy results were obtained. Three-dimensional liver tomography was used to assess liver volume. Actual graft weight was measured on the back table after perfusion. Graft types were recorded. A discrepancy of more than 10% is accepted as discordant. The possible reasons were evaluated.

Results

The mean estimated liver volume and radiological liver volume were 1216 cm3 and 1290 cm3, respectively. The mean radiological right lobe volume and the actual right lobe graft weight were 815 and 846, respectively. Liver density, liver steatosis percentage, blood cholesterol levels, blood triglyceride levels, and blood total bilirubin levels are factors contributing to the disparity between the estimated and radiological volume differences. Vitamin B12 and albumin levels were associated with the discrepancy between radiological liver volume and actual graft weight. Underestimation was significant in the left lateral lobe.

Conclusions

Three-dimensional volumetry is useful for size matching. Discrepancies of more than 10% are attributable to liver steatosis or splitting lines.