J Korean Soc Radiol.  2013 Nov;69(5):377-384. 10.3348/jksr.2013.69.5.377.

Factors Influencing Liver and Spleen Volume Changes after Donor Hepatectomy for Living Donor Liver Transplantation

• Bae JH
• Ryeom H
• Song JH

• KMID: 2002859
• DOI: http://doi.org/10.3348/jksr.2013.69.5.377

Abstract

PURPOSE
To define the changes in liver and spleen volumes in the early postoperative period after partial liver donation for living-donor liver transplantation (LDLT) and to determine factors that influence liver and spleen volume changes.
MATERIALS AND METHODS
27 donors who underwent partial hepatectomy for LDLT were included in this study. The rates of liver and spleen volume change, measured with CT volumetry, were correlated with several factors. The analyzed factors included the indocyanine green (ICG) retention rate at 15 minutes after ICG administration, preoperative platelet count, preoperative liver and splenic volumes, resected liver volume, resected-to-whole liver volume ratio (LV(R)/LV(W)), resected liver volume to the sum of whole liver and spleen volume ratio [LV(R)/(LV(W) + SV(0))], and pre and post hepatectomy portal venous pressures.
RESULTS
In all hepatectomy donors, the volumes of the remnant liver and spleen were increased (increased rates, 59.5 +/- 50.5%, 47.9 +/- 22.6%). The increment rate of the remnant liver volume revealed a positive correlation with LV(R)/LV(W) (r = 0.759, p < 0.01). The other analyzed factors showed no correlation with changes in liver and spleen volumes.
CONCLUSION
The spleen and remnant liver volumes were increased at CT volumetry performed 2 weeks after partial liver donation. Among the various analyzed factors, LV(R)/LV(W) influences the increment rate of the remnant liver volume.

MeSH Terms

Hepatectomy*
Humans
Indocyanine Green
Liver Transplantation*
Liver*
Living Donors*
Platelet Count
Postoperative Period
Spleen*
Tissue Donors*
Indocyanine Green

Figure

• 

  Fig. 1 CT scans of a 25-year-old male donor. A, B. CT scans obtained preoperatively (A) and 14 days after the right hepatectomy (B) at the level of the left portal vein (arrows) show postoperative enlargement of the remnant left hepatic lobe. The immediate postoperative remnant left hepatic lobe volume calculated by CT volumetry and intraoperative measurement was 509.82 cm3 (area encircled by a white line in A) and the left lobe volume measured 2 weeks after right hepatectomy was increased to 1085.25 cm3 (area encircled by a white line in B). C, D. CT images obtained preoperatively (C) and 14 days after right hepatectomy (D) show postoperative enlargement of the spleen (arrows). By CT volumetry, the preoperative splenic volume was 255.97 cm3 and the splenic volume 2 weeks after right hepatectomy was increased to 397.30 cm3.

• 

  Fig. 2 The original liver volume versus the liver volume at 2 weeks after donor hepatectomy. Note.-LVW = whole liver volume at donation, LV2wks = liver volume at 2 weeks after hepatectomy

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  Fig. 3 Volume changes of the remnant liver. The remnant liver showed increment of volumes two weeks after hepatectomy (p < 0.01). Note.-LV0 = remnant liver volume immediately after donation, LV2wks = liver volume at 2 weeks after hepatectomy

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  Fig. 4 Splenic volume change. There was a statistically significant increment in splenic volume at 2 weeks after liver donation (p < 0.01). Note.-SV0 = spleen volume at donation, SV2wks = spleen volume at 2 weeks after hepatectomy

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  Fig. 5 The correlation between the increment rate of the remnant liver and relative volume of the resected liver to the whole liver. The percent remnant liver volume increase (%LV0 increase) revealed positive correlation with the resected-to-whole liver volume ratio (LVR/LVW) (r = 0.759, p < 0.01). Note.-LVR = resected liver volume, LVW = whole liver volume at donation, LV0 = remnant liver volume immediately after donation

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