Relationship Between Liver Size and Body Size

DeLand, Frank H.; North, Wendy A.

doi:10.1148/91.6.1195

Cited by 142 publications

(126 citation statements)

References 1 publication

Supporting

Mentioning

112

Contrasting

Unclassified

Order By: Relevance

“…Our regression line was compared (Figure 4) with the two previously reported formulas obtained from autopsy data of Western populations. 7,18 The formula from Heinemann et al 7 from Germany, reporting on 1,332 "Caucasians," overestimates TLV in our sample by 91.88 Ϯ 44.69 (SD) cm 3 , whereas the formula from DeLand and North 18 from the Johns Hopkins Hospital (which does not indicate patient race) slightly overestimates TLV by 1.71 Ϯ 74.20 (SD) cm 3 .…”

Section: Resultscontrasting

confidence: 57%

“…The current formula is based on computed tomographic measurements, and its validity is corroborated by the close correlation with two formulas derived from Western autopsy studies. 7,18 This study was undertaken based on data showing that computed tomographic volumetric analysis correlates with actual liver volume. 5,19,20 Previous studies showed errors in computed tomographic volume calculation that included the partial-volume effect and respiratory-phase and interobserver variation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Body surface area and body weight predict total liver volume in Western adults

Vauthey¹

2002

Liver Transplantation

538

436

View full text Add to dashboard Cite

Computed tomography (CT) is used increasingly to measure liver volume in patients undergoing evaluation for transplantation or resection. This study is designed to determine a formula predicting total liver volume (TLV) based on body surface area (BSA) or body weight in Western adults. TLV was measured in 292 patients from four Western centers. Liver volumes were calculated from helical computed tomographic scans obtained for conditions unrelated to the hepatobiliary system. BSA was calculated based on height and weight. Each center used a different established method of three-dimensional volume reconstruction. Using regression analysis, measurements were compared, and formulas correlating BSA or body weight to TLV were established. A linear regression formula to estimate TLV based on BSA was obtained: TLV ‫؍‬ I n the past decade, the role of computed tomography (CT) has extended beyond its use for liver imaging to include three-dimensional volumetric measurement before liver transplantation or major hepatic resection. [1][2][3][4] This has been possible because of a close correlation between the volume obtained by three-dimensional reconstruction of computed tomographic images and actual liver volume. 5 In a recent Japanese study, a formula that enables calculation of total liver volume (TLV) from body surface area (BSA) was generated after study of CT-based three-dimensional volumetric measurement of livers of children and adults. This formula has been applied to calculate the graft to TLV ratio for living related donor liver transplantation 4,6 and the future liver remnant (FLR) to TLV ratio before liver resection. 2 However, the formula has not gained general acceptance at Western centers, and its accuracy has been questioned because of Western autopsy measurements that indicate on average a TLV of 323 cm 3 greater than expected based on the Japanese formula. 7 In addition, body weight, rather than BSA, has been used to estimate graft volume before liver transplantation, particularly donorrecipient weight ratio. [8][9][10] However, to our knowledge, the correlation between body weight and TLV has not been evaluated.In addition to the issue of liver size match, the goal of preoperative liver volume estimation is to estimate hepatic metabolic demands of an individual patient. 11 Thus, a method that estimates appropriate volume based on patient characteristics (e.g., patient weight or BSA) in combination with a measure of liver volume (by CT) is desirable. Although caloric needs, total body water, and extracellular water correlate more closely to BSA than body weight in children, differences are minor. 12,13 Therefore, either weight or BSA could provide a standard means to estimate liver function, as well as size, before resection or transplantation.We designed a multicenter study to evaluate the correlation between TLV and BSA or body weight in Western patients with normal livers who underwent CT for conditions unrelated to the hepatobiliary system. The newly derived formula based on BSA then was

show abstract

Section: Resultscontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Body surface area and body weight predict total liver volume in Western adults

Vauthey¹

2002

Liver Transplantation

538

436

View full text Add to dashboard Cite

show abstract

“…Lo et al 24 reported a successful LRLT in an adult patient, using a graft weighing 25% of the recipient' s estimated SLV. In their report, they calculated the estimated standard liver mass according to the early study by Deland et al, 25 who investigated the relationship between the body surface area and liver weight in autopsy cases in the United States. We have established a formula for calculating recipients' SLVs from their body surface areas, based on a volumetric analysis using computed tomography in patients with normal livers whose disease conditions do not seem to affect the body weight or liver volume.…”

Section: Discussionmentioning

confidence: 99%

Living-related liver transplantation for patients with fulminant and subfulminant hepatic failure

et al. 1999

View full text Add to dashboard Cite

The prognosis for patients with fulminant (FHF) or subfulminant hepatic failure (SFHF) has improved since the introduction of liver transplantation. However, the death rate of patients awaiting liver transplantation is high, possibly because of the difficulty in obtaining grafts in a timely manner, given the relative shortage of cadaveric donors. Between June 1990 and June 1999, 106 patients underwent living-related liver transplantation (LRLT) at Shinshu University Hospital. Among them, 8 patients had FHF and 6 had SFHF; these 14 patients are the subjects of this report. The graft volumes (GV) ranged from 231 mL to 625 mL, corresponding to 35% to 105% of the recipients' standard liver volume (SLV). The postoperative courses of all donors were uneventful. Following liver transplantation, all grafts functioned favorably, with normalization of serum total bilirubin within 3 to 5 days and normalization of coagulation profiles within 4 to 7 days. Thirteen of the 14 recipients are still alive. The actuarial 6-month, 1-year, and 5-year survival rates were 100%, 90%, and 90%, respectively. In the present study, when the ratio of the GV to the recipient's SLV was more than 35%, the graft was able to support the patient's metabolic demand after liver transplantation for FHF or SFHF. Because of the urgent nature of liver transplantation in this clinical condition, concerns over informed consent may be even greater than for elective LRLT. Nevertheless, the high success rate and low donor risk may justify this option for pediatric patients, as well as for a limited population of adult patients suffering from FHF or SFHF. (HEPATOLOGY 1999;30:1521-1526.)The prognosis for patients with fulminant hepatic failure (FHF) and subfulminant hepatic failure (SFHF) has improved since the introduction of orthotopic liver transplantation. 1 The survival rate of patients with these conditions who undergo liver transplantation is in the range of 56% to 80%, 2-4 compared with the 15% to 20% survival rate of patients who do not undergo transplantation, even with improved medical treatment. 5 Because FHF is rapidly progressive and irreversible, the need for liver transplantation is urgent. The death rate of patients awaiting liver transplantation is as high as 40% 6 or 62%, 7 possibly as a result of the difficulty of obtaining grafts in a timely manner, given the relative shortage of cadaveric donors.Living-related liver transplantation (LRLT) has been developed as an alternative to cadaveric liver transplantation. To avoid ethical dilemmas in LRLT, including any potential coercion of the live donor candidates, we have pursued a strict policy of ensuring that the participants in LRLT are fully informed of all aspects and risks of the procedure before we obtain their consent. As favorable results for LRLT have accumulated, reluctance toward the procedure has gradually subsided. Given this success, it is worth considering LRLT for patients with FHF, provided that each situation is considered with special care because of the short amount of time...

show abstract

“…This implies that body weight may be a more important factor in predicting liver volume in this population. In fact, four of twelve reported studies showed that BW is more significant than BSA [6,7,9,18]. Body weight is preferred as a primary index, and is obtained by precise weighing measurement as opposed to BSA, which is a secondary index estimated using few possible formulas.…”

Section: Discussionmentioning

confidence: 99%