Tuberous sclerosis (TS) is an autosomal dominant phakomatosis. A high percentage of spontaneous mutations leads to the diagnosis of new cases in normal families. This diagnosis is suspected at antenatal ultrasound on the discovery of multiple cardiac tumors. Antenatal cerebral ultrasound shows a normal appearance in affected fetuses. Eight fetuses with multiple cardiac tumors were studied with antenatal MRI with, in five cases, an abnormal appearance showing hyperintense subependymal and cortical nodules on T1-weighted images. Among the three remaining patients MRI was non-contributive in one due to movement artefact, one had abnormal postnatal MRI consistent with TS and one had a normal postnatal and clinical examination. We conclude that MRI is a valuable tool in making the diagnosis of TS in fetuses with multiple cardiac tumors.

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Julie Duclos and Prashant Bhangui are co-first authors.The partial liver's ability to regenerate both as a graft and remnant justifies right lobe (RL) living donor liver transplantation. We studied (using biochemical and radiological parameters) the rate, extent of, and predictors of functional and volumetric recovery of the remnant left liver (RLL) during the first year in 91 consecutive RL donors. Recovery of normal liver function (prothrombin time [PT] !70% of normal and total bilirubin [TB] 20 mmol/L), liver volumetric recovery, and percentage RLL growth were analyzed. Normal liver function was regained by postoperative day's 7, 30, and 365 in 52%, 86%, and 96% donors, respectively. Similarly, mean liver volumetric recovery was 64%, 71%, and 85%; whereas the percentage liver growth was 85%, 105%, and 146%, respectively. Preoperative PT value (p ¼ 0.01), RLL/total liver volume (TLV) ratio (p ¼ 0.03), middle hepatic vein harvesting (p ¼ 0.02), and postoperative peak TB (p < 0.01) were predictors of early functional recovery, whereas donor age (p ¼ 0.03), RLL/ TLV ratio (p ¼ 0.004), and TLV/ body weight ratio (p ¼ 0.02) predicted early volumetric recuperation. One-year post-RL donor hepatectomy, though functional recovery occurs in almost all (96%), donors had incomplete restoration (85%) of preoperative total liver volume. Modifiable predictors of regeneration could help in better and safer donor selection, while continuing to ensure successful recipient outcomes.Abbreviations: ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; BSA, body surface area; CT, computed tomography scan; GGT, gamma glutamyl transpeptidase; ICG RT15 , indocyanine green retention rate at 15 min; ISGLS, International Study Group of Liver Surgery; MHV, middle hepatic vein; PHLF, posthepatectomy liver failure; POD, postoperative day; PT, prothrombin time; RL, right lobe; RLL, remnant left liver; RLLDLT, right lobe living donor liver transplantation; RLL/BW, remnant left liver to body weight ratio; RLL/TLV, remnant left liver to total liver volume ratio; SLV, standard liver volume; TB, serum total bilirubin; TLV, total liver volume

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