Measurement of liver volume in patients with advanced liver disease is used to gauge the appropriate size of donor organs and may have prognostic value. We sought to determine the accuracy of magnetic resonance imaging (MRI) in measuring liver volume in 19 adult patients under consideration for liver transplantation. We also correlated the liver volume determination to the clinical severity of disease. Liver volume was measured at MRI by averaging the calculated volumes from coronal and transverse breath-hold T1-weighted images. These results were compared to the explanted liver volume measured by fluid displacement and the explant mass. The correlation coefficient for MRI liver volume and n many centers, patients being considered for I liver transplantation undergo hepatic ultrasound to assess vascular patency and contrast-enhanced computed tomography (CT) to measure liver size and to screen for hepatocellular cancer. Estimation of liver volume by noninvasive means often provides useful information for donor matching' and for assessing prognosis2In order to decrease the number of tests and avoid potentially nephrotoxic iodinated contrast agents, we began to use magnetic resonance imaging (MRI) of the liver to perform tumor screening, assess vascular patency, and estimate liver sue. In the present study, we sought to determine the accuracy of MRI in measuring liver volume by comparing the estimated liver volume at MRI to the explant displacement volume and mass. The calculated volume from the MRI was further analyzed for its relation to the clinical severity of liver disease.
We conclude that patients with recurrent or de novo hepatitis B after OLTX can be successfully retransplanted using aggressive immunoprophylaxis to prevent HBV reinfection. The failure of HBIg therapy in one patient underscores the need for other effective adjunctive anti-HBV modalities.
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