Reliability of CT volumetry as a tool to calculate the preoperative donor liver volume: Correlation with the intraoperative graft weight in living donor liver transplantation (LDLT)

Authors : Sachal Sharma, Sachal Sharma, Sajal Jain, Sajal Jain, Chandermohan , Chandermohan , Payal Malhotra, Payal Malhotra

DOI : 10.18231/j.jsas.2020.015

Volume : 2

Issue : 3

Year : 2020

Page No : 95-98

Introduction: Liver transplantation has become an ideal management for end stage liver diseases. The
preoperative volumetric assessment of donor liver is an important factor in determining the surgical
strategy and in predicting post operative donor and recipient mortality and morbidity. CT has high spatial
and contrast resolution and provides comprehensive parenchymal vascular and volumetric preoperative
evaluation of donor undergoing live donor liver transplant and its accuracy can be established by comparing
it with the intraoperative actual graft volume.
Materials and Methods : 52 patients who underwent donor right hepatectomy were included in the
study and underwent CT scanning during the period from July 2017 to June 2019. Manual tracing of
CT volumetry was done for calculating liver volume. The actual liver volume is obtained by weighing
the graft immediately after resection. The difference between preoperative CT volume and intraoperative
graft weight was defined as a percentage error ratio, which was classified as overestimation (+) and
underestimation (-).
Results: In 28 (53.8%) cases, right lobe liver grafts obtained including MHV, whereas in 24(46.2%)
cases right liver lobe grafts obtained excluding MHV. The mean preoperative liver volume calculated
was 816.5+ 142.5g, while the mean volume measured intraoperatively was 812.6 g + 136.8g. The mean
volume difference between preoperative and actual graft volume was 51.96+33.65cm3(range 4-131cm3).
The mean error ratio was 6.59+4.623%. 30(57.7%) cases had underestimation, whereas 22(42.3%) cases
had overestimation of liver volume. The mean preoperative volume had a good correlation with actual graft
volume.
Conclusion: The present study concludes that CT volumetry accurately predicted preoperative graft
volume and showed excellent correlation with actual graft volume.

Keywords: Transplantation, Graft, Volumetry, Donor, .CT


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