Comparison of Semi-Automated Ct Volumetry and Intraoperative Graft Weight in Potential Donors for Living Donor Liver Transplantation (Ldlt)

Abstract

Aim: The aim is to study the correlation between estimated graft weight (EGW) and actual graft weight (AGW) in potential donors for LDLT. Materials and Methods: The study cohort consisted of 133 right lobe (RL) with middle hepatic vein (MHV), 23 RL without MHV and 17 left lobe (LL) grafts assessed between August 2018 and August 2020. EGW was calculated using semi-automated volumetry technique in Philips IntelliSpace portal workstation and AGW was measured intra-operatively by the transplant team after graft retrieval from the donor. To find the agreement between AGW and EGW, intra-class correlation co-efficient (ICC) was computed. To find the degree of correlation between EGW and AGW, Spearman’s rho correlation co-efficient was computed. Bland Altman plot was used for assessing the level of agreement between two methods. Results: The mean age of donors was 38.9 +/- 9.9 years (Female:Male::121:52). The correlation between EGW and AGW for all three types of grafts was significant (p<0.001). RL with MHV: Spearman’s rho r=0.786, ICC=0.883; RL without MHV: Spearman’s rho r= 0.968, ICC=0.986 and LL: Spearman’s rho r= 0.809, ICC=0.937. Bland Altman’s analysis showed that CT volumetry overestimated 5 and underestimated 1 RL grafts with MHV, overestimated 1 RL grafts without MHV and underestimated 1 LL grafts. Conclusion: CT volumetry has a definitive role in the pre-operative evaluation of prospective liver donors. EGW calculated by semi-automated CT volumetry in potential LDLT donors is accurate and correlates well with AGW measured intra-operatively for both right and left lobe grafts.