Application of 3D Reconstruction Software for Preoperative Evaluation of Split and Living Donor Liver Volume in Liver Transplantation.

BACKGROUND AND AIM: The effectiveness of liver transplantation depends on the precise estimation of the donors' liver volume, particularly in split and living donor liver transplantation. In this study, the volume of the split donor liver graft was assessed, and accurate surgical planning was performed using the Hisense computer-assisted surgery system (Hisense CAS).

METHODS

Based on computed tomography images, we used Hisense CAS to reconstruct the donor liver and generate clear 3D images of donor liver volume, vessels, and bile ducts. Subsequently, the volumes of the split liver grafts, including the left lateral lobe, extended right half graft, left half, and right half, were measured. These measurements were then compared with the intraoperatively measured volumes. We also used the system to monitor postoperative changes in liver volume regeneration.

RESULTS

We effectively reconstructed 3D images of 62 donors and 80 recipients, and compared the preoperatively estimated volumes with the intraoperatively measured volumes for the following graft types: left lateral lobe in 27 cases (living donor, 15 cases; donation after brain death [DBD], 12 cases), extended right half graft in 21 cases (DBD, 21 cases), left half in 14 cases (living donor, 7 cases; DBD, 7 cases), and right half in 18 cases (living donor, 11 cases; DBD, 7 cases). There were no statistically significant differences between the estimated and measured volumes for any graft type. Following split and living donor liver transplantation, the donor liver volume was monitored, and the results showed that one month after transplantation, the donor liver volume regenerated to near-normal liver volume.

CONCLUSION

Our results showed that donor liver volume can be precisely determined using 3D reconstruction software (Hisense CAS). There were no statistically significant differences between the volume estimated by reconstruction and the actual volume measured intraoperatively.