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A Comparison of Actual Graft Weight and Estimated Graft Volume Calculated with New Software Used for Anatomical and Volumetric Analysis of the Liver with Computed Tomography in Living Liver Donors

Year 2021, Volume: 11 Issue: 2, 96 - 101, 25.08.2021
https://doi.org/10.26650/experimed.2021.942836

Abstract

Objective: In the living donor liver transplantation (LDLT) context, accurate estimation of the graft weight to recipient weight ratio (GRWR) and future donor liver remnant volume by pre-operative volumetric analysis is very important. We aimed to compare the estimated graft volume (EGV) calculated with the LiverVision® soft-ware with the actual graft weight (AGW) measured in the back-ta-ble in this study.

Material and Method: Patients who underwent right lobe LDLT and liver donors between 01.01.2018-30.05.2020 were retrospec-tively evaluated. Demographic data, body mass index, EGV, AGW and GRWR were recorded. Linear regression analysis, Pearson cor-relation coefficient and Bland-Altman plots were utilized for evalu-ation of the relationships between continuous variables.

Results: A total of 108 liver donors were included in the study. The mean age of the donors was 32.6±8.8 years and mean EGV was 902.5±147.1 mL for all donors. The mean AGW was 890.6±145.9 g for all donors. A significant correlation was found between EGV and AGW for all donors (r=0.856, p<0.001). The mean difference between EGV and AGW was 11.9±78.5 for all donors. 105 of the 108ith CT with the newly developed Turkish semi-automatic LiverVision® software. (97.2%) measurements were within the 95% ranges of agreement be-tween EGV and AGW according to the Bland-Altman plot. According to the regression model created to calculate the AGW, the formula AGW (g)=0.85xEGV (mL)+124.5 was obtained (r2=0.732, p<0.001).

Conclusion: The liver volumes of the donors were successfully estimat-ed with computed tomography (CT) with the newly developed Turkish semi-automatic LiverVision® software.

Thanks

Acknowledgments: The authors thank to Professor Ayşe Canan Yazıcı Güvercin for the statistical analysis of this study. Department of Biostatistics and Medical Informatics, Istanbul Aydin University Faculty of Medicine, acyazici@gmail.com, Beşyol mahallesi, İnönü Cd. No:38, Küçükçekmece, 34295, İstanbul, Turkey.

References

  • 1. Zakareya T, Abbasy M, Abdel-Razek W, Abdelkader Salama I, Deif M. A novel formula for graft weight estimation from preoperative computed tomography volumetric measurement in living donor liver transplantation. Transplant Technol 2017; 5:1. google scholar
  • 2. Bozkurt B, Emek E, Arikan T, Ceyhan O, Yazici P, Sahin T, et al. Liver Graft Volume Estimation by Manual Volumetry and Software-Aided Interactive Volumetry: Which is Better? Transplant Proc 2019; 51(7): 2387-90. google scholar
  • 3. Van Thiel DH, Hagler NG, Schade RR, Skolnick ML, Pollitt Heyl A, Rosenblum E, et al. In vivo hepatic volume determination using sonography and computed tomography. Gastroenterology 1985; 88: 1812-17. [CrossRef] google scholar
  • 4. Yoneyema T, Asonuma K, Okajima H, Lee KJ, Yamamoto H, Takeichi T, et al. Coefficient factor for graft weight estimation from preoperative computed tomography volumetry in living donor liver transplantation. Liver Transpl 2011; 17: 369-72. [CrossRef] google scholar
  • 5. Lui SA, Bonney GK, Kow WCA, Iyer SG, Chang SKY, Madhavan KK. Standard Formulae in Predicting Liver Volumes: A South East Asian series of Adult Living Donors. Transplant Technol Res 2016; 6: 153. google scholar
  • 6. Satou S, Sugawara Y, Tamura S, Yamashiki N, Kaneko J, Aoki T, et al. Discrepancy between estimated and actual weight of partial liver graft from living donors. J Hepatobiliary Pancreat Sci 2011;18(4): 586-91. [CrossRef] google scholar
  • 7. Heymsfield SB, Fulenwider T, Nordlinger B, Barlow R, Sones P, Kutner M. Accurate measurement of the liver, kidney and spleen volume and mass by computerized axial tomography. Ann Intern Med 1979; 90: 185-7. [CrossRef] google scholar
  • 8. Kamel IR, Kruskal JB, Warmbrand G, Goldberg SN, Pomfret EA, Raptopoulos V. Accuracy of volumetric measurements after virtual right hepatectomy in potential donors undergoing living adult liver transplantation. AJR Am J Roentgenol 2001; 176: 483-7. [CrossRef] google scholar
  • 9. Harada N, Shimada M, Yoshizumi T, Suehiro T, Soejima Y, Maehara Y. A simple and accurate formula to estimate left hepatic graft volume in living-donor adult liver transplantation. Transplantation 2004; 77: 1571-5. [CrossRef] google scholar
  • 10. Salvalaggio PR, Baker TB, Koffron AJ, Fryer JP, Clark L, Superina RA, et al. Liver graft estimation in 100 living donors: measure twice, cut once. Transplantation 2005; 80: 1181-5. [CrossRef] google scholar
  • 11. Lemke AJ, Brinkmann MJ, Schott T, Niehues SM, Settmacher U, Neuhaus P, et al. Living donor right liver lobes: preoperative CT volumetric measurement for calculation of intraoperative weight and volume. Radiology 2006; 240: 736-42. [CrossRef] google scholar
  • 12. Sonnemans LJ, Hol JC, Monshouwer R, Prokop M, Klein WM. Correlation between liver volumetric computed tomography results and measured liver weight: A tool for preoperative planning of liver transplant. Exp Clin Transplant 2016; 1: 72-78. google scholar
  • 13. Jachowski C, Thali MJ, Buck U, Aghayev E, Sonnenschein M, Yen K, et al. Noninvasive estimation of organ weights by postmortem magnetic resonance imaging and multislice computed tomography. Invest Radiol 2006; 41(7): 572-8. [CrossRef] google scholar
  • 14. Kim KW, Lee J, Lee H, Jeong WK, Won HG, Shin YM, et al. Right lobe estimated blood-free weight for living donor liver transplantation: accuracy of automated blood-free CT volumetry - preliminary results. Radiology 2010; 256: 433-40. [CrossRef] google scholar
  • 15. Hwang S, Lee S, Kim K, Park K, Ahn C, Moon D, et al. Correlation of blood-free graft weight and volumetric graft volume by an analysis of blood content in living donor liver grafts. Transplant Proc 2002; 34: 3293-4. [CrossRef] google scholar

Canlı Karaciğer Vericilerinde Karaciğerin Bilgisayarlı Tomografi ile Anatomik ve Hacimsel Analizi için Kullanılan Yeni Bir Yazılım Programı ile Hesaplanan Tahmini Greft Hacmi ile Gerçek Greft Ağırlığının Karşılaştırılması

Year 2021, Volume: 11 Issue: 2, 96 - 101, 25.08.2021
https://doi.org/10.26650/experimed.2021.942836

Abstract

Amaç: Canlı vericili karaciğer naklinde, alıcıda greftin alıcı ağırlığı-na oranının (GRWR) ve vericide ameliyat sonrası kalacak karaciğer hacminin ameliyat öncesi hacimsel analizle doğru tahmin edilmesi çok önemlidir. Bu çalışma ile karaciğer vericilerinde karaciğerin anatomik ve hacimsel analizinin yapılması için kullandığımız LiverVision® programı ile hesaplanmış tahmini sağ lob greft hacimlerinin (EGV) ameliyat sırasında arka-masada (back-table) ölçülen gerçek greft ağırlığı (AGW) ile karşılaştırılması amaçlanmıştır.

Gereç ve Yöntem: Çalışmamızda 01.01.2018-30.05.2020 tarihleri arasında canlı vericiden sağ lob karaciğer nakli yapılmış olan hastalar ve vericileri retrospektif olarak incelenmiştir. Hastaların demog-rafik bulguları, vücut kitle indeksi, EGV, AGW ve GRWR kayıt altına alınmıştır. Sürekli değişkenler arasındaki ilişkiler, Pearson korelasyon katsayısı, doğrusal regresyon analizi ve Bland Altman grafikleri ile değerlendirilmiştir.

Bulgular: Ortalama yaşı 32,6±8,8 yıl olan toplam 108 karaciğer vericisi çalışmaya dâhil edilmiştir. Ortalama EGV tüm vericiler için, 902,5±147,1 mL iken, ortalama AGW tüm vericiler için 890,6±145,9 g olarak hesaplanmıştır. Tüm vericiler için EGV ile AGW arasında anlamlı bir korelasyon olduğu saptanmıştır (r=0,856, p<0,001). Bland-Altman metoduna göre 108 ölçümün 105'inde (%97,2) EGV, AGW ile %95 güven aralığı içerisinde saptanmıştır. AGW’yi hesaplamak için oluşturulan regresyon modeline göre AGW (g)=0,85xEGV (mL)+124,5 formülü elde edilmiştir (r2=0,732, p<0,001).

Sonuç: Yeni geliştirilmiş Türk yapımı yarı otomatik LiverVision® yazılımı ile bilgisayarlı tomografi (BT) ile vericilerin karaciğer hacimleri başarılı bir şekilde tahmin edilebilmektedir.

References

  • 1. Zakareya T, Abbasy M, Abdel-Razek W, Abdelkader Salama I, Deif M. A novel formula for graft weight estimation from preoperative computed tomography volumetric measurement in living donor liver transplantation. Transplant Technol 2017; 5:1. google scholar
  • 2. Bozkurt B, Emek E, Arikan T, Ceyhan O, Yazici P, Sahin T, et al. Liver Graft Volume Estimation by Manual Volumetry and Software-Aided Interactive Volumetry: Which is Better? Transplant Proc 2019; 51(7): 2387-90. google scholar
  • 3. Van Thiel DH, Hagler NG, Schade RR, Skolnick ML, Pollitt Heyl A, Rosenblum E, et al. In vivo hepatic volume determination using sonography and computed tomography. Gastroenterology 1985; 88: 1812-17. [CrossRef] google scholar
  • 4. Yoneyema T, Asonuma K, Okajima H, Lee KJ, Yamamoto H, Takeichi T, et al. Coefficient factor for graft weight estimation from preoperative computed tomography volumetry in living donor liver transplantation. Liver Transpl 2011; 17: 369-72. [CrossRef] google scholar
  • 5. Lui SA, Bonney GK, Kow WCA, Iyer SG, Chang SKY, Madhavan KK. Standard Formulae in Predicting Liver Volumes: A South East Asian series of Adult Living Donors. Transplant Technol Res 2016; 6: 153. google scholar
  • 6. Satou S, Sugawara Y, Tamura S, Yamashiki N, Kaneko J, Aoki T, et al. Discrepancy between estimated and actual weight of partial liver graft from living donors. J Hepatobiliary Pancreat Sci 2011;18(4): 586-91. [CrossRef] google scholar
  • 7. Heymsfield SB, Fulenwider T, Nordlinger B, Barlow R, Sones P, Kutner M. Accurate measurement of the liver, kidney and spleen volume and mass by computerized axial tomography. Ann Intern Med 1979; 90: 185-7. [CrossRef] google scholar
  • 8. Kamel IR, Kruskal JB, Warmbrand G, Goldberg SN, Pomfret EA, Raptopoulos V. Accuracy of volumetric measurements after virtual right hepatectomy in potential donors undergoing living adult liver transplantation. AJR Am J Roentgenol 2001; 176: 483-7. [CrossRef] google scholar
  • 9. Harada N, Shimada M, Yoshizumi T, Suehiro T, Soejima Y, Maehara Y. A simple and accurate formula to estimate left hepatic graft volume in living-donor adult liver transplantation. Transplantation 2004; 77: 1571-5. [CrossRef] google scholar
  • 10. Salvalaggio PR, Baker TB, Koffron AJ, Fryer JP, Clark L, Superina RA, et al. Liver graft estimation in 100 living donors: measure twice, cut once. Transplantation 2005; 80: 1181-5. [CrossRef] google scholar
  • 11. Lemke AJ, Brinkmann MJ, Schott T, Niehues SM, Settmacher U, Neuhaus P, et al. Living donor right liver lobes: preoperative CT volumetric measurement for calculation of intraoperative weight and volume. Radiology 2006; 240: 736-42. [CrossRef] google scholar
  • 12. Sonnemans LJ, Hol JC, Monshouwer R, Prokop M, Klein WM. Correlation between liver volumetric computed tomography results and measured liver weight: A tool for preoperative planning of liver transplant. Exp Clin Transplant 2016; 1: 72-78. google scholar
  • 13. Jachowski C, Thali MJ, Buck U, Aghayev E, Sonnenschein M, Yen K, et al. Noninvasive estimation of organ weights by postmortem magnetic resonance imaging and multislice computed tomography. Invest Radiol 2006; 41(7): 572-8. [CrossRef] google scholar
  • 14. Kim KW, Lee J, Lee H, Jeong WK, Won HG, Shin YM, et al. Right lobe estimated blood-free weight for living donor liver transplantation: accuracy of automated blood-free CT volumetry - preliminary results. Radiology 2010; 256: 433-40. [CrossRef] google scholar
  • 15. Hwang S, Lee S, Kim K, Park K, Ahn C, Moon D, et al. Correlation of blood-free graft weight and volumetric graft volume by an analysis of blood content in living donor liver grafts. Transplant Proc 2002; 34: 3293-4. [CrossRef] google scholar
There are 15 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Ümit Özçelik 0000-0003-1073-2494

Eryiğit Eren 0000-0001-6705-4095

Yıldıray Tutpınar This is me 0000-0001-9445-6604

Devrim Urut This is me 0000-0003-4763-8645

Mehmet Tokac 0000-0002-7278-0937

Ayhan Dinçkan This is me 0000-0003-1395-333X

Publication Date August 25, 2021
Submission Date June 1, 2021
Published in Issue Year 2021 Volume: 11 Issue: 2

Cite

Vancouver Özçelik Ü, Eren E, Tutpınar Y, Urut D, Tokac M, Dinçkan A. A Comparison of Actual Graft Weight and Estimated Graft Volume Calculated with New Software Used for Anatomical and Volumetric Analysis of the Liver with Computed Tomography in Living Liver Donors. Experimed. 2021;11(2):96-101.