Transplantation proceedings · 2009
Remission of splenic volume in the recipient during the course of adult-to-adult living donor liver transplantation: evaluation using multislice computed tomography and semiautomatic software.
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Ishifuro M, Horiguchi J, Ohshita A, Itamoto T, Ohdan H, Ito K
Аннотация
AIM: The purpose of the study was to examine changes in splenic volume among recipients during the course of adult-to-adult living donor liver transplantation (LDLT) using multislice computed tomography (CT) scanning with a semiautomatic volumetry software.
MATERIALS AND METHODS: Forty-eight patients, including 33 males and a mean overall age of 54 +/- 8 years), underwent liver transplantation for the primary disease of liver cirrhosis with or without hepatocellular carcinoma (n = 31/17, respectively). The mean MELD score was 14 +/- 6. The liver graft mass compared with recipient weight was 74% +/- 28%. Splenic artery embolization was not performed. Dynamic CT scans splenic volume, and platelet counts (10(3)/cm(3)) were obtained pre, < or =50 day and > or =90 days postoperatively.
RESULTS: The total time to generate volumetry and image postprocessing per examination was <10 minutes. One-factor analysis of variance (ANOVA) revealed that the average splenic volume tended to be reduced from pre- to post-LDLT, although not significantly: pre-LDLT, 469 +/- 270 mL; < or =day 50, 369 +/- 212 mL; and > or =day 90, 378 +/- 210 mL (P = .066). One-factor ANOVA revealed that the average platelet count was significantly different in the 3 periods: pre-LDLT, 69 +/- 32 x 10(3)/cm(3); < or =day 50, 181 +/- 253 x 10(3)/cm(3); and > or =day 90, 126 +/- 64 x 10(3)/cm(3) (P < .01). The post hoc Scheffé test revealed the statistical significance of the platelet counts between pre-LDLT and < or =day 50 (P < .01).
CONCLUSION: Splenic volumetry with multislice CT and semiautomatic software, which is simple and not time consuming, was able to evaluate remission from hypersplenism during the course of LDLT.
MATERIALS AND METHODS: Forty-eight patients, including 33 males and a mean overall age of 54 +/- 8 years), underwent liver transplantation for the primary disease of liver cirrhosis with or without hepatocellular carcinoma (n = 31/17, respectively). The mean MELD score was 14 +/- 6. The liver graft mass compared with recipient weight was 74% +/- 28%. Splenic artery embolization was not performed. Dynamic CT scans splenic volume, and platelet counts (10(3)/cm(3)) were obtained pre, < or =50 day and > or =90 days postoperatively.
RESULTS: The total time to generate volumetry and image postprocessing per examination was <10 minutes. One-factor analysis of variance (ANOVA) revealed that the average splenic volume tended to be reduced from pre- to post-LDLT, although not significantly: pre-LDLT, 469 +/- 270 mL; < or =day 50, 369 +/- 212 mL; and > or =day 90, 378 +/- 210 mL (P = .066). One-factor ANOVA revealed that the average platelet count was significantly different in the 3 periods: pre-LDLT, 69 +/- 32 x 10(3)/cm(3); < or =day 50, 181 +/- 253 x 10(3)/cm(3); and > or =day 90, 126 +/- 64 x 10(3)/cm(3) (P < .01). The post hoc Scheffé test revealed the statistical significance of the platelet counts between pre-LDLT and < or =day 50 (P < .01).
CONCLUSION: Splenic volumetry with multislice CT and semiautomatic software, which is simple and not time consuming, was able to evaluate remission from hypersplenism during the course of LDLT.