Paluszkiewicz R, Zieniewicz K, Kalinowski P, Hevelke P, Grzelak I, Pacho R, Krawczyk M
Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
Transplant Proc. 2009 Oct;41(8):2981-4. doi: 10.1016/j.transproceed.2009.08.014.
Living-related liver transplantation for pediatric patients has become an acceptable, low-risk treatment option. The aim of this study was to assess the extent of donor liver regeneration.
Between October 1999 and January 2008, 120 living-related donors provided 109 grafts consisting of segments II and III and 11 grafts consisting of segments II, III, and IV. Volumetric assessment of the donor liver and selected segments was performed using computed tomography. After procurement every graft was weighed. At 7 and 30 days, as well as 12 months after the operation the donor liver remnant was evaluated for differences in volume.
A significant correlation was observed between the liver graft mass and its volume as assessed by computed tomography (r = 0.781; P < .05). Twelve months after procurement, the average regeneration index was significantly higher among donors of segments II, III, and IV (144 +/- 23%) versus donors of segments II and III (114 +/- 15%; P < .05).
Liver regeneration after procurement of selected liver segments from living donors is a consistent finding. Computed tomography is an accurate imaging modality to track changes in liver volume. This study showed a positive correlation between the size of the liver graft and the regeneration of the liver remnant in the donor.
亲属活体肝移植已成为小儿患者可接受的低风险治疗选择。本研究的目的是评估供体肝脏的再生程度。
1999年10月至2008年1月期间，120名亲属活体供体提供了109个由Ⅱ段和Ⅲ段组成的移植物以及11个由Ⅱ段、Ⅲ段和Ⅳ段组成的移植物。使用计算机断层扫描对供体肝脏和选定节段进行容积评估。获取移植物后，对每个移植物进行称重。在术后7天、30天以及12个月时，对供体肝脏残余部分的体积差异进行评估。
通过计算机断层扫描评估，观察到肝移植物质量与其体积之间存在显著相关性（r = 0.781；P < 0.05）。获取移植物12个月后，Ⅱ段、Ⅲ段和Ⅳ段供体的平均再生指数显著高于Ⅱ段和Ⅲ段供体（144 ± 23% 对 114 ± 15%；P < 0.05）。
从活体供体获取选定肝段后肝脏再生是一个一致的发现。计算机断层扫描是追踪肝脏体积变化的准确成像方式。本研究表明肝移植物大小与供体肝脏残余部分的再生之间存在正相关。
