Hirata Y, Sanada Y, Urahashi T, Ihara Y, Yamada N, Okada N, Tashiro M, Katano T, Otomo S, Ushijima K, Mizuta K
Department of Transplant Surgery, Jichi Medical University, Shimotsuke City, Tochigi, Japan.
Department of Transplant Surgery, Jichi Medical University, Shimotsuke City, Tochigi, Japan.
Transplant Proc. 2016 May;48(4):1105-9. doi: 10.1016/j.transproceed.2015.12.089.
Although there have been a few reports describing the changes of graft liver and spleen volumes after liver transplantation (LT), little is known about the relationship between graft liver function and the changes of these volumes after technical variant liver transplantation (TVLT). We therefore performed a retrospective study to investigate the relationship between graft liver function and these volumes after TVLT.
We retrospectively investigated the cases of 140 TVLT procedures that were performed in our department between July 1987 and October 2012 and in which follow-up was conducted at our department. We calculated the graft liver volume to standard liver volume (GV/SLV) ratio, the spleen volume to standard spleen volume (SV/SSV) ratio, and the spleen volume to graft liver volume (S/L) ratio by CT volumetry. We clarified the relationship between graft liver function (according to the pathological findings) and the graft liver and spleen volumes at 2, 5, and 10 years after TVLT.
In the normal liver function group, the GV/SLV, SV/SSV, and S/L ratios decreased until 6 months after TVLT and then converged at 10 years after TVLT to 0.95, 1.27, and 0.27, respectively. In the graft liver failure group, the GV/SLV, SV/SSV, and S/L ratios at 10 years after TVLT were 0.67, 5.01, and 1.55, respectively. A significant correlation was observed between the GV/SLV ratio and the presence of mild liver fibrosis at 2 and 5 years after TVLT (P = .03 and P = .04, respectively).
Post-transplant CT-volumetry is a noninvasive and effective means of evaluating graft liver status.
尽管已有一些报告描述了肝移植（LT）后移植肝和脾脏体积的变化，但对于技术变异肝移植（TVLT）后移植肝功能与这些体积变化之间的关系知之甚少。因此，我们进行了一项回顾性研究，以探讨TVLT后移植肝功能与这些体积之间的关系。
我们回顾性调查了1987年7月至2012年10月在我科进行的140例TVLT手术病例，并在我科进行了随访。通过CT容积测量法计算移植肝体积与标准肝体积（GV/SLV）之比、脾脏体积与标准脾脏体积（SV/SSV）之比以及脾脏体积与移植肝体积（S/L）之比。我们明确了TVLT后2年、5年和10年时移植肝功能（根据病理结果）与移植肝和脾脏体积之间的关系。
在肝功能正常组中，GV/SLV、SV/SSV和S/L比值在TVLT后6个月内下降，然后在TVLT后10年分别收敛至0.95、1.27和0.27。在移植肝衰竭组中，TVLT后10年的GV/SLV、SV/SSV和S/L比值分别为0.67、5.01和1.55。TVLT后2年和5年时，GV/SLV比值与轻度肝纤维化的存在之间存在显著相关性（分别为P = 0.03和P = 0.04）。
移植后CT容积测量是评估移植肝状态的一种无创且有效的方法。
