The correlation between preoperative volumetry and real graft weight: comparison of two volumetry programs

Abstract

PurposeLiver volumetry is a vital component in living donor liver transplantation to determine an adequate graft volume that meets the metabolic demands of the recipient and at the same time ensures donor safety. Most institutions use preoperative contrast-enhanced CT image-based software programs to estimate graft volume. The objective of this study was to evaluate the accuracy of 2 liver volumetry programs (Rapidia vs. Dr. Liver) in preoperative right liver graft estimation compared with real graft weight.MethodsData from 215 consecutive right lobe living donors between October 2013 and August 2015 were retrospectively reviewed. One hundred seven patients were enrolled in Rapidia group and 108 patients were included in the Dr. Liver group. Estimated graft volumes generated by both software programs were compared with real graft weight measured during surgery, and further classified into minimal difference (≤15%) and big difference (>15%). Correlation coefficients and degree of difference were determined. Linear regressions were calculated and results depicted as scatterplots.ResultsMinimal difference was observed in 69.4% of cases from Dr. Liver group and big difference was seen in 44.9% of cases from Rapidia group (P = 0.035). Linear regression analysis showed positive correlation in both groups (P < 0.01). However, the correlation coefficient was better for the Dr. Liver group (R2 = 0.719), than for the Rapidia group (R2 = 0.688).ConclusionDr. Liver can accurately predict right liver graft size better and faster than Rapidia, and can facilitate preoperative planning in living donor liver transplantation.

Preoperative Evaluation of Living Donor Liver Volume in Living Donor Liver Transplantation

“…The ratio of the calculated volume and the weight of the graft should be at least 0.8% in order to protect the recipient from small-for-size phenomena (cellular damage, liver with decreased capacity for metabolism, synthesis, ascites), and the ratio should be <3% to avoid large-for-size phenomena (poor liver perfusion, increased abdominal pressure). The volume of the remaining liver should be at least 30% to protect the donor from life-threatening consequences [ 1 ].…”

Short-term outcomes after major hepatic resection in patients with cirrhosis: a 75-case unicentric western experience

“…It is widely accepted that studies using intraoperative liver volumetric measurements are based on the assumption that the density value is on the order of 1 g/mL, to facilitate the conversion of volumetric values to weight values. 20…”

Should We Have Blind Faith in Liver Volumetry?

“…To the best of our knowledge, this is the first study to have evaluated the performance of liver volumetry involving numerous software programs and clinicians (multicentic evaluation) because most previously published studies only compared two or three software used by a few operators [8,9,11,15,22,23,30]. Our work therefore reflects the practices actually applied in French HPB centres.…”

“…In terms of liver volumetric calculations, some authors have also reported clinically significant inter-and intra-observer variability, but the reliability of this tool remains widely accepted because of the statistically strong correlation between estimates and intraoperative measurements in most series [22,23]. Given this apparent contradiction (statistical vs clinical significance), our goal was to evaluate the reliability of volumetric assessment in the settings of deceased-donor liver transplantation (DDLT) (cirrhotic livers) and LDLT (healthy livers), aiming to determine the true difference between volumetric estimations and intraoperative measurements.…”