Liver regeneration in the first week after living donor liver transplantation: evaluation with sonography.

BACKGROUND/AIMS: Liver regeneration is a crucial issue after adult-to-adult living donor liver transplantation A-ALDLT. Several studies have shown the rapid enlargement of liver size 3 months after surgery but how the liver regenerate in the first postoperative week remains unknown. The purpose of our study was to investigate liver regeneration in the first postoperative week using sonography.

METHODOLOGY

Twenty pairs of donors and recipients undergone A-ALDLT were enrolled between March 2007 and January 2008. A linear regression was done to determine the relationship between the preoperative donor liver volumetric measurements by CT and ultrasound. The volume of graft liver was obtained by water bath during surgery and by ultrasound daily in the first postoperative week.

RESULTS

Liver volume of the 20 donors measured by CT and ultrasound were 1367.8±193.7cm3 and 1281.1±149.3cm3, respectively. The sonographic measurement correlated well with that of CT (r=0.93, p <0.0001). The mean volume of ex vivo graft livers was 595±193.7cm3. Hepatic volume increased sharply, by 42.31% at postoperative day one and 93.5% at postoperative day seven.

CONCLUSIONS

Sonographic measurement of liver volume is accurate. Bedside ultrasound is a useful ancillary test to assess liver regeneration in early postoperative days. Liver regenerated vigorously in A-ALDLT recipients in the first postoperative week.