Ann Hepatobiliary Pancreat Surg.  2021 May;25(2):192-197. 10.14701/ahbps.2021.25.2.192.

Comparison of skeletal muscle index-based formula and body surface area-based formula for calculating standard liver volume

• Yang G
• Hwang S
• Song GW
• Jung DH

• KMID: 2516239
• DOI: http://doi.org/10.14701/ahbps.2021.25.2.192

Abstract

Backgrounds/Aims
Formula-derived standard liver volume (SLV) has been clinically used for living donor liver transplantation and hepatic resection. The majority of currently available SLV formulae are based on body surface are (BSA). However, they often show a wide range of error. Skeletal muscle index measured at the third lumbar vertebra level (L3SMI) appears to reflect lean body mass. The objective of this study was to compare the accuracy of L3SMI-based formula and BSA-based formula for calculating SLV.
Methods
The study cohort was 500 hundred living liver donors who underwent surgery between January 2010 and December 2013. Computed tomography images were used for liver volumetry and skeletal muscle area measurement.
Results
The study cohort included 250 male and 250 female donors. Their age, BSA, L3SMI, and body mass index were 26.8±8.7 years, 1.68±0.16 m² , 45.6±9.0 cm² /m² , and 21.7±2.5 kg/m² , respectively. The BSA-based SLV formula was “SLV (ml)=−362.3+901.5×BSA (m² ) (r=0.71, r² =0.50, p＜0.001)”. The L3SMI-based SLV formula was “SLV (ml)=471.9+14.9×L3SMI (cm² /m² ) (r=0.65, r² =0.42, p＜0.001)”. Correlation coefficients were similar in subgroup analyses with 250 male donors and 250 female donors. There was a crude correlation between L3SMI and body mass index (r=0.51, r² =0.27, p＜0.001).
Conclusions
The results of this study suggest that SLV calculation with L3SMI-based formula does not appear to be superior to the currently available BSA-based formulae.

Keyword

Standard liver volume; Body surface area; Skeletal muscle index; Sarcopenia; Liver transplantation

Figure

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  Fig. 1 Samples of skeletal muscle area measurement at the third lumbar vertebra level (L3). (A) A 19-year-old male with body mass index (BMI) 20.8 kg/m2, skeletal muscle index at L3 (L3SMI) 55.6 cm2/m2, total liver volume 1210 (TLV) ml, and L3SMI-based standard liver volume (SLV) 1294 ml. (B) A 28-year-old male with BMI 24.6 kg/m2, L3SMI 53.2 cm2/m2, TLV 1329 ml, and L3SMI-based SLV 1265 ml. (C) A 31-year-old female with BMI 22.5 kg/m2, L3SMI 47.5 cm2/m2, TLV 1066 ml, and L3SMI-based SLV 1197 ml. (D) A 21-year-old female with BMI 28.9 kg/m2, L3SMI 45.1 cm2/m2, TLV 1071 ml, and L3SMI-based SLV 1169 ml.

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  Fig. 2 Scatter plots of standard liver volume formulae using body surface area (A) and skeletal muscle index (B) in 500 donors.

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  Fig. 3 Scatter plots of standard liver volume formulae using body surface area (A) and skeletal muscle index (B) in 250 male donors.

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  Fig. 4 Scatter plots of standard liver volume formulae using body surface area (A) and skeletal muscle index (B) in 250 female donors.

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  Fig. 5 Scatter plots for correlation between the skeletal muscle index and body mass index in 500 donors.

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