Analysis of factors associated with discrepancies between predicted and observed liver weight in liver transplantation

Abstract

Background: Even using predictive formulas based on anthropometrics in about 30% of subjects, liver weight (LW) cannot be predicted with a ≤20% margin of error. We aimed to identify factors associated with discrepancies between predicted and observed LW. Methods:In 500 consecutive liver grafts, we tested LW predictive performance using 17 formulas based on anthropometric characteristics. Hashimoto's formula (961.3 × BSA_D-404.8) was associated with the lowest mean absolute error and used to predict LW for the entire cohort. Clinical factors associated with a ≥20% margin of error were identified in a multivariable analysis after propensity score matching (PSM) of donors with similar anthropometric characteristics. Results:The total LW was underestimated with a ≥20% margin of error in 53/500

Graft weight integration in the early allograft dysfunction formula improves the prediction of early graft loss after liver transplantation

“…In the Training-Set cohort, livers were weighed using a digital scale after removing the surrounding non-hepatic tissues. Since the GW in the Validation-Set were not available at the time of data collection, after a careful evaluation of the available formulas in the English literature and an estimation of the acceptable discrepancy between the actual and estimated weight in the Training-Set [ 9 ] the weight was estimated (estGW) using the following formula: estimated standard liver weight (g) = 218 + body weight (kg) × 12.3 + gender (female 0; male: 1) × 51] [ 10 ]. In the Training and Validation-Set, the liver biopsies were analyzed by the same local expert pathologists at Tor Vergata University, Sapienza University, and Erasmus MC, respectively.…”

Combination of Donor Anthropometrics With Recipient Imaging to Improve Matching in Liver Transplantation

“…Using these formulas, the graft weight is underestimated with a ≥20% margin of error in 10.6% of donors and overestimated in 12% of donors. (3) Factors associated with an increased risk of error are related to the donor's age, the presence of obesity, and the reanimation length. (3) In the formulas of patients with cirrhosis based on anthropometrics, liver volume is underestimated with a ≥20% margin of error in 30% of patients and overestimated in 22.5% of patients.…”

Using small size grafts in live donor liver transplantation: Is graft size important?

“…Therefore, it is crucial to determine the most appropriate lower limit of GRWR for donors and living donor liver transplant recipients because if lower threshold values are accepted, donors will have a more limited chance of performing hepatectomy [1]. In addition, in this case, potential liver donors will be more encouraged to donate [7,8].…”