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

Başkıran, Adil; Kahraman, Ayşegül Sağır; ÇİÇEK, İpek BALIKÇI; Sahin, Tevfik Tolga; Işık, Burak; Yilmaz, Sezai

doi:10.14744/nci.2017.14227

Cited by 7 publications

(10 citation statements)

References 10 publications

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“…Nevertheless, the study showed a statistically significant change between all three measurements, as well as a statistically significant difference in liver volume between inspiratory and expiratory states. These results form the basis of the arguments put forth in this discussion, and other studies assessing preoperative planning and intraoperative volume show corroborating evidence [ 25 , 51 , 52 , 58 , 60 – 62 ]. Consistent with the recommendations to keep the number of animal experiments as low as possible, e.g., 3Rs (reduction, replacement, refinement) and PREPARE guidelines we chose to not perform additional experiments since the current number of animals was sufficient for statistical evaluation with the current focus of the study.…”

Section: Discussionsupporting

confidence: 83%

“…In regards to preoperative planning, differences in preoperative measured volume and in situ volume have been recorded previously. In volumetric analysis of living donor transplant livers, Baskiran et al described significant reductions between estimated and intraoperative volumes [ 52 ], and correctly stressed the need for surgical awareness to prevent small-for-size and large-for-size errors. The current study should underline this finding, and further emphasize that liver volume must be critically re-evaluated in the intraoperative setting, especially in laparoscopic procedures.…”

Section: Discussionmentioning

confidence: 99%

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Effects of laparoscopy, laparotomy, and respiratory phase on liver volume in a live porcine model for liver resection

et al. 2021

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Background Hepatectomy, living donor liver transplantations and other major hepatic interventions rely on precise calculation of the total, remnant and graft liver volume. However, liver volume might differ between the pre- and intraoperative situation. To model liver volume changes and develop and validate such pre- and intraoperative assistance systems, exact information about the influence of lung ventilation and intraoperative surgical state on liver volume is essential. Methods This study assessed the effects of respiratory phase, pneumoperitoneum for laparoscopy, and laparotomy on liver volume in a live porcine model. Nine CT scans were conducted per pig (N = 10), each for all possible combinations of the three operative (native, pneumoperitoneum and laparotomy) and respiratory states (expiration, middle inspiration and deep inspiration). Manual segmentations of the liver were generated and converted to a mesh model, and the corresponding liver volumes were calculated. Results With pneumoperitoneum the liver volume decreased on average by 13.2% (112.7 ml ± 63.8 ml, p < 0.0001) and after laparotomy by 7.3% (62.0 ml ± 65.7 ml, p = 0.0001) compared to native state. From expiration to middle inspiration the liver volume increased on average by 4.1% (31.1 ml ± 55.8 ml, p = 0.166) and from expiration to deep inspiration by 7.2% (54.7 ml ± 51.8 ml, p = 0.007). Conclusions Considerable changes in liver volume change were caused by pneumoperitoneum, laparotomy and respiration. These findings provide knowledge for the refinement of available preoperative simulation and operation planning and help to adjust preoperative imaging parameters to best suit the intraoperative situation.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Effects of laparoscopy, laparotomy, and respiratory phase on liver volume in a live porcine model for liver resection

et al. 2021

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“…1,2 Some studies have reported an error ratio of 10% to 20%. [8][9][10] In our study, the mean error ratio was 6.59+4.623%.…”

Section: Discussionmentioning

confidence: 41%

“…Baskiran et al 10 reported that age and BMI had a significant impact on the error percentage while gender did not. In present study, donor's age and gender didn't have any significant agreement with error percentage (p=0.500, 0.523 respectively) and overestimation or underestimation (p=0.881,0.740 respectively).…”

Section: Discussionmentioning

confidence: 99%

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)

Sharma¹,

Jain²,

Chandermohan³

et al. 2020

JSAS

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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+33.65cm 3 (range 4-131cm 3). 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.

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“…Volume estimation accuracy of a healthy organ or a pathological structure influences patient management outcome (1,2). Difficulties and inaccuracies encountered in clinical volume assessments compel clinicians to rely on image-assisted methodology (3).…”

Section: Introductionmentioning

confidence: 99%

Impact of volume calculation formulae on volume estimation accuracy of different shaped objects: an in vitro ultrasound and CT study

Kodikara

Gamage²,

Abeysekara

et al. 2020

Acta Radiol

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Background In image-assisted volume estimation, the volume of the object is calculated with a formula, using linear measurements of the objects. Since the volume estimation accuracy is thought to be influenced by the shape of the object, the volume estimation error would be related to the calculation formula used. Purpose To evaluate the volume estimation accuracy of selected volume calculation formulae, for different shaped objects. Material and Methods Globular (n = 5), elongated (n = 5), and near-spherical shaped plastic objects (n = 5), filled with water were subjected to ultrasound (US) and computed tomography (CT) in February 2018, to obtain the length, width, depth, and estimated volumes (EV). The volume was calculated manually using prolate, ellipsoid, and Lambert formulae. The actual volume (AV), EV, and calculated volumes were compared. Results The AV was in the range of 10–445 mL. The reliability of measurements was high as assessed by the intra-class variability (Cronbach’s alpha = 0.992). The EV has shown a high correlation to AV (US: ρ = 0.914, P < 0.001; CT: ρ = 0.943, P < 0.001; ellipsoid: ρ = 0.876, P < 0.001; prolate: ρ = 0.891, P < 0.001; Lambert: ρ = 0.876, P < 0.001). Regardless of the shape, the highest and lowest estimation accuracies were reported for prolate (bias = −0.7) and Lambert formulae (bias = +23.3), respectively. By any method, the globular objects were estimated with the highest accuracy: (US [bias = −0.31]; CT [bias = −0.14]; ellipsoid [bias = −1.5]; prolate [bias = −0.7]; Lambert [bias = 32.9]); and elongated objects were estimated with the lowest accuracy: (US [bias = −17.5]; CT [bias = −32.6]; ellipsoid [bias = −18.4]; prolate [bias = −0.3]; Lambert [bias = 11.4]). Conclusion The shape of the object and the calculation formula used has an impact on the volume estimation accuracy.

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

Cited by 7 publications

References 10 publications

Effects of laparoscopy, laparotomy, and respiratory phase on liver volume in a live porcine model for liver resection

Effects of laparoscopy, laparotomy, and respiratory phase on liver volume in a live porcine model for liver resection

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)

Impact of volume calculation formulae on volume estimation accuracy of different shaped objects: an in vitro ultrasound and CT study

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