Canlı vericili karaciğer transplantasyonu öncesi intraoperatif olarak ölçülen greft ağırlığının tahmininde bilgisayarlı tomografinin rolü

Yıl 2019, Cilt: 18 Sayı: 2, 39 - 43, 15.09.2019

Mustafa Özdemir Halil Özer Yiğit Düzköylü Rıza Sarper Ökten Fatma Ayça Edis Özdemir

https://doi.org/10.17941/agd.620844

Öz

Giriş ve Amaç: Bu çalışmanın amacı canlıdan karaciğer transplantasyonunda
greftin değerlendirilmesinde bilgisayarlı tomografi ile ölçülen tahmini greft volümünden korreksiyon faktörü
kullanılarak hesaplanan tahmini greft ağırlığı ile gerçek greft ağırlığının karşılaştırılması
ve bu korreksiyon faktörünün efektivitesinin araştırılmasıdır. Gereç ve Yöntem: Ocak
2009-Temmuz 2015 tarihleri arasında 42 canlı karaciğer donörünün (20 kadın, 22
erkek; ortalama yaş, 42.23 yıl±17.25 (18-52) dinamik kontrastlı hepatik bilgisayarlı tomografi kesitlerinden elde
edilen veriler retrospektif olarak tarandı. Donörler, karaciğer nakli için
karaciğer sağ lob rezeksiyonu yapılan sağlıklı erişkinlerdi. Bilgisayarlı tomografi ile ölçülen tahmini greft volümü (cc) Lemke ve
arkadaşlarının formülü (tahmini greft ağırlığı (g):
0.678 x tahmini greft volümü (cc)
+143.704 g) kullanılarak tahmin edildi. Tahmini
greft ağırlığı ile gerçek greft ağırlığı arasındaki
ilişkiyi saptamak için Pearson korelasyon testi kullanıldı. Bulgular: Ameliyat öncesi ortalama karaciğer hacmi 918.265 (580-1230) cc
idi. Ameliyat öncesi tahmini greft ağırlığı ve
gerçek greft ağırlığı ortalama ağırlıkları sırasıyla 818.119 (550-1171) gr, 790.359
(505-1150) gr ölçüldü. Gerçek greft ağırlığı ile preoperatif tahmini greft
volümü arasında istatistiksel bir ilişki yoktu. Ancak gerçek greft ağırlığı ile preoperatif tahmini greft
ağırlığı arasında güçlü bir istatistiksel ilişki tespit edildi. Pearson
korelasyon analizi sonuçları güçlü bir korelasyon gösterdi (r = 0.98, p
<0.001) ve regresyon modelinin sonucu bu bulguyu destekledi (p <0.0001). Sonuç: Sonuç olarak canlıdan
karaciğer naklinde greftin değerlendirilmesinde bilgisayarlı tomografi ile ölçülen volümün gerçek
ağırlıktan farklı olduğu, Lemke ve ark.’nın geliştirdiği formülün aktüel
ağırlığı tahminde yeterli ve etkili olduğu tespit edildi.

Anahtar Kelimeler

Karaciğer nakli, bilgisayarlı tomografi, organ boyutu

Role of computed tomography in estimating graft weight measured intraoperatively before living donor liver transplantation

Öz

Background and Aims: The aim of our
study was to evaluate the graft in an alive donor liver for transplantation
using computerized tomography (CT) estimated graft volume, which is calculated
by comparing the estimated graft weight with the actual graft weight through a
correction factor and its efficacy. Materials and Methods: The dynamic
contrast-enhanced hepatic computerized tomography scans of 42 alive liver
donors (20 females, 22 males; mean [standard deviation, range] age, 42.23
[17.25, 18–52] years), consecutively registered from January 2009 to July 2015
were retrospectively analyzed in this study. The donors were healthy adults who
had undergone resection of the right liver lobe for liver transplantation. The
calculated estimated graft volume was compared with the actual intraoperative
graft weight of the harvested right hepatic lobe. Results: The mean preoperative liver volume was found to be 918.265 (580–1230)
cc. The mean (range) calculated preoperative estimated graft weight and the
actual graft weight were 818.119 (550–1171) g and 790.357 (505–1150) g,
respectively. No significant association was found between the actual graft
weight and the preoperative estimated graft volume. However, there was a strong
statistical association between the actual graft weight and preoperative
estimated graft weight. The Pearson’s correlation analysis revealed a strong
correlation (r = 0.98, p < 0.001), and the result of the regression model
supported the finding (P < 0.0001). Conclusions: We found that the computerized
tomography-estimated graft volume is different from the preoperative actual
weight, and the current formula used worldwide is adequate and efficient for
predicting the actual weight for evaluating the graft in a living donor liver
for transplantation.

Anahtar Kelimeler

Liver transplantation, tomography, organ size

Kaynakça

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