The Importance of Predicting the Differance between Preoperative Estimated Graft Volume and Intraoperative Actual Graft Volume on Donor Selection in Adult Living Donor Liver Transplantation: A Single Center Experience

Authors

1 Department of General Surgery, Ain Shams University, Cairo, Egypt

2 Department of Radiology, Faculty of Medicine, Ain Shams University

Abstract

Backgrounds: In living donor liver transplantation, a difference between the intraoperative actual right lobe graft
weight and the preoperative CT volumetric estimation is frequently seen, which may has an impact on the safety
of living donors and the prognosis of recipients.
Objective: Our aim of the study was how to predict the difference between intraoperative actual and preoperative
estimated right lobe graft weight and graft-recipient body weight ratio in adult living donor liver transplantation.
Methods: Our study was conducted on 400 donors who involved in adult right lobe liver transplantation at
Ain Shams Center for Organ Transplantation (ASCOT) between 2008 and 2020.Preoperative right lobe liver graft
volumetry was performed with dynamic hepatic computed tomography (CT) using automatic volume calculating
software and compared with actual intraoperative blood free graft weight which obtained after hepatectomy using
automated electronic scale.
Results: The Mean donor age was 27.9 ± 6.78 years old, and 292 of the donors were males. The mean preoperatively estimated graft volume was 917.4±156.2 g and the mean intraoperative measured actual graft volume was 798±150 g. There was a statistically significant difference (p=0.0001). A mean±SD of difference between estimated and actual liver volume is 12.8±4.2%.
Conclusion: Surgeons who specialize in liver transplantation should be aware that there is a discrepancy between the estimated and actual graft volume. The weight of the right lobe graft can be predicted preoperatively by reducing the preoperatively estimated liver volume by 12-14%. Also, actual right lobe volume = 249.7 + 0.59 (Estimated right lobe volume).

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