Liver Regeneration in 120 Consecutive Living-Related Liver Donors

Paluszkiewicz, Rafał; Zieniewicz, Krzysztof; Kalinowski, Piotr; Hevelke, Piotr; Grzelak, I; Pacho, Ryszard; Krawczyk, Marek

doi:10.1016/j.transproceed.2009.08.014

Cited by 11 publications

(21 citation statements)

References 18 publications

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“…Our study collective is unique, since liver regeneration was documented during a long follow-up period of up to 84 months (mean 24 months). Concordantly to previous studies, we found that remaining liver tissue was highly regenerative in the early period after donation [7,9,10]. The liver volume before donation was almost restored after 6 months.…”

Section: Postoperative Complicationssupporting

confidence: 92%

“…The influencing factors of liver regeneration are still not fully understood. Identified factors, which compromise liver regeneration are liver steatosis and donor age [10]. Growth factors (e. g. EGF, HGF) and cytokines (TNF-alpha) stimulate growth of liver tissue via autocrine and endocrine pathways, and therefore play an important role in liver regeneration [27].…”

Section: Right Liver Donors Left Lateral Section (Ii Iii) Left Lobe mentioning

confidence: 99%

“…It is influenced by graft size, donor age, and presence of the middle hepatic vein, and has been evaluated in short-term follow-up studies [7,8]. It has been shown that the FLR has the strongest regenerative potential within the first weeks after donation [7,9,10]. Computed tomography (CT) and magnetic resonance imaging (MRI) play important roles in the evaluation of liver donors.…”

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confidence: 99%

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Liver Remnant Regeneration in Donors After Living Donor Liver Transplantation: Long-Term Follow-Up Using CT and MR Imaging

Klink

Simon

Knopp

et al. 2013

Fortschr Röntgenstr

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Purpose: To assess liver remnant volume regeneration and maintenance, and complications in the long-time follow-up of donors after living donor liver transplantation using CT and MRI. Materials and Methods: 47 donors with a mean age of 33.5 years who donated liver tissue for transplantation and who were available for follow-up imaging were included in this retrospective study. Contrast-enhanced CT and MR studies were acquired for routine follow-up.?Two observers evaluated pre- and postoperative images regarding anatomy and pathological findings. Volumes were manually measured on contrast-enhanced images in the portal venous phase, and potential postoperative complications were documented. Pre- and postoperative liver volumes were compared for evaluating liver remnant regeneration. Results: 47 preoperative and 89 follow-up studies covered a period of 22.4 months (range: 1???84). After right liver lobe (RLL) donation, the mean liver remnant volume was 522.0?ml (??144.0; 36.1?%; n?=?18), after left lateral section (LLS) donation 1,121.7?ml (??212.8; 79.9?%; n?=?24), and after left liver lobe (LLL) donation 1,181.5?ml (??279.5; 72.0?%; n?=?5). Twelve months after donation, the liver remnant volume were 87.3?% (RLL; ??11.8; n?=?11), 95.0?% (LS; ??11.6; n?=?18), and 80.1?% (LLL; ??2.0; n?=?2 LLL) of the preoperative total liver volume. Rapid initial regeneration and maintenance at 80?% of the preoperative liver volume were observed over the total follow-up period.?Minor postoperative complications were found early in 4 patients. No severe or late complications or mortality occurred. Conclusion: Rapid regeneration of liver remnant volumes in all donors and volume maintenance over the long-term follow-up period of up to 84 months without severe or late complications are important observations for assessing the safety of LDLT donors. Key Points: Liver remnant volumes of LDLT donors rapidly regenerated after donation and volumes were maintained over the long-term follow-up period of up to 84 months without severe or late complications. Citation Format: ??Klink T, Simon P, Knopp C et?al. Liver Remnant Regeneration in Donors After Living Donor Liver Transplantation: Long-Term Follow-Up Using CT and MR Imaging. Fortschr R?ntgenstr 2014; 186: 598???605

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Section: Postoperative Complicationssupporting

confidence: 92%

Section: Right Liver Donors Left Lateral Section (Ii Iii) Left Lobe mentioning

confidence: 99%

mentioning

confidence: 99%

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Liver Remnant Regeneration in Donors After Living Donor Liver Transplantation: Long-Term Follow-Up Using CT and MR Imaging

Klink

Simon

Knopp

et al. 2013

Fortschr Röntgenstr

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“…Some studies have demonstrated the high regenerative potential of liver remnants in short‐term periods after hepatectomy . Ibrahim et al reported that the LRR at 6 months was 90.7%, and other studies reported that the LRR at 1 year ranged from 83.0% to 97.2% . Yokoi et al reported the highest LRR (97.2%) and stated that it may require at least 1 year after hepatectomy for donor livers to be restored to their original volume.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 Some studies have investigated short-term outcomes following donor hepatectomy, and they have reported the highly regenerative potential of the liver remnants in donors between a few days up to 12 months after donation. 1,[4][5][6][7][8][9][10][11] However, other studies have reported that full regeneration was achieved in only a small percentage of the donors at 6 months, 5,7 and only a few reports have investigated liver restoration at later timepoints. [12][13][14] It has been well documented that splenic enlargement occurs in the postoperative period following major hepatic resection.…”

Section: Introductionmentioning

confidence: 99%

Long-term impact and clinical significance of living donor liver transplantation with respect to donor liver restoration and spleen size: A prospective study

Yoshino

Taura

Ikeno

et al. 2020

American Journal of Transplantation

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This study aimed to evaluate postoperative long‐term liver restoration and splenic enlargement and their clinical significance in living donor liver transplantation. One hundred and sixteen donors who had donated livers more than 5 years previously accepted the invitation to participate in this study. The liver restoration rate and the splenic enlargement rate were calculated as the rate with respect to the original volume. The mean liver restoration rate was 0.99 ± 0.12 and older age was associated with a higher incidence for liver restoration rate <0.95 (P = .005), whereas type of donor operation was not. The donors with liver restoration rate <0.95 showed lower serum albumin levels than those with liver restoration rate ≥0.95. The mean splenic enlargement rate was 1.10 ± 0.16. Right lobe donors demonstrated higher splenic enlargement rate (1.14 ± 0.18) than left lobe/lateral segment donors (1.06 ± 0.13). In the donors with splenic enlargement rate ≥1.10, platelet count was not fully restored to the preoperative level. In conclusion, older age increases the risk for incomplete postoperative liver restoration, which may be associated with a decrease in albumin more than 5 years after donation. Right lobe donation poses a risk of splenic enlargement, which is associated with incomplete restoration of platelet count.

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Impact of early postoperative platelet count on volumetric liver gain and perioperative outcomes after major liver resection

Margonis

Amini

Buettner

et al. 2016

British Journal of Surgery

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Liver Regeneration in 120 Consecutive Living-Related Liver Donors

Cited by 11 publications

References 18 publications

Liver Remnant Regeneration in Donors After Living Donor Liver Transplantation: Long-Term Follow-Up Using CT and MR Imaging

Liver Remnant Regeneration in Donors After Living Donor Liver Transplantation: Long-Term Follow-Up Using CT and MR Imaging

Long-term impact and clinical significance of living donor liver transplantation with respect to donor liver restoration and spleen size: A prospective study

Impact of early postoperative platelet count on volumetric liver gain and perioperative outcomes after major liver resection

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