Department of Surgery, University of Hong Kong, Hong Kong, China.
Liver Transpl. 2011 Dec;17(12):1437-42. doi: 10.1002/lt.22430.
An accurate assessment of donor and recipient liver volumes is essential in living donor liver transplantation. Many liver donors are affected by mild to moderate steatosis, and steatotic livers are known to have larger volumes. This study analyzes errors in liver volume estimation by commonly used formulas and the effects of donor steatosis on these errors. Three hundred twenty-five Asian donors who underwent right lobe donor hepatectomy were the subjects of this study. The percentage differences between the liver volumes from computed tomography (CT) and the liver volumes estimated with each formula (ie, the error percentages) were calculated. Five popular formulas were tested. The degrees of steatosis were categorized as follows: no steatosis [n = 178 (54.8%)], ≤ 10% steatosis [n = 128 (39.4%)], and >10% to 20% steatosis [n = 19 (5.8%)]. The median errors ranged from 0.6% (7 mL) to 24.6% (360 mL). The lowest was seen with the locally derived formula. All the formulas showed a significant association between the error percentage and the CT liver volume (P < 0.001). Overestimation was seen with smaller liver volumes, whereas underestimation was seen with larger volumes. The locally derived formula was most accurate when the liver volume was 1001 to 1250 mL. A multivariate analysis showed that the estimation error was dependent on the liver volume (P = 0.001) and the anthropometric measurement that was used in the calculation (P < 0.001) rather than steatosis (P ≥ 0.07). In conclusion, all the formulas have a similar pattern of error that is possibly related to the anthropometric measurement. Clinicians should be aware of this pattern of error and the liver volume with which their formula is most accurate.
在活体肝移植中，准确评估供体和受体的肝体积至关重要。许多肝供体受轻度至中度脂肪变性的影响，已知脂肪变性的肝脏体积较大。本研究分析了常用公式在肝体积估计中的误差以及供体脂肪变性对这些误差的影响。本研究的对象是 325 名接受右叶供肝切除术的亚洲供体。计算了 CT 肝体积与每个公式估计的肝体积之间的百分比差异（即误差百分比）。测试了 5 种流行的公式。脂肪变性程度分为以下几类：无脂肪变性[ n = 178（54.8％）]，≤10％脂肪变性[ n = 128（39.4％）]和> 10％至 20％脂肪变性[ n = 19（5.8％）]。中位数误差范围为 0.6％（7 毫升）至 24.6％（360 毫升）。本地衍生公式的误差最低。所有公式均显示误差百分比与 CT 肝体积之间存在显著相关性（P <0.001）。较小的肝体积存在高估，而较大的体积则存在低估。当肝体积为 1001 至 1250 毫升时，本地衍生公式最为准确。多元分析显示，估计误差取决于肝体积（P = 0.001）和计算中使用的人体测量值（P <0.001），而不是脂肪变性（P≥0.07）。总之，所有公式都具有相似的误差模式，该模式可能与人体测量值有关。临床医生应了解这种误差模式以及其公式最准确的肝体积。
