成人活体肝移植术前计算机断层扫描体积测量与移植物重量估计

PREOPERATIVE COMPUTED TOMOGRAPHY VOLUMETRY AND GRAFT WEIGHT ESTIMATION IN ADULT LIVING DONOR LIVER TRANSPLANTATION.

作者信息

Pinheiro Rafael S, Cruz Ruy J, Andraus Wellington, Ducatti Liliana, Martino Rodrigo B, Nacif Lucas S, Rocha-Santos Vinicius, Arantes Rubens M, Lai Quirino, Ibuki Felicia S, Rocha Manoel S, D Albuquerque Luiz A C

机构信息

Digestive Organ Transplantation Division, Department of Gastroenterology, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.

Transplantation Division, Department of Surgery, University of L'Aquila; San Salvatore Hospital, Italy.

出版信息

Arq Bras Cir Dig. 2017 Jan-Mar;30(1):38-41. doi: 10.1590/0102-6720201700010011.

DOI:10.1590/0102-6720201700010011

PMID:28489167

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5424685/

Abstract

BACKGROUND

Computed tomography volumetry (CTV) is a useful tool for predicting graft weights (GW) for living donor liver transplantation (LDLT). Few studies have examined the correlation between CTV and GW in normal liver parenchyma.

AIM

To analyze the correlation between CTV and GW in an adult LDLT population and provide a systematic review of the existing mathematical models to calculate partial liver graft weight.

METHODS

Between January 2009 and January 2013, 28 consecutive donors undergoing right hepatectomy for LDLT were retrospectively reviewed. All grafts were perfused with HTK solution. Estimated graft volume was estimated by CTV and these values were compared to the actual graft weight, which was measured after liver harvesting and perfusion.

RESULTS

Median actual GW was 782.5 g, averaged 791.43±136 g and ranged from 520-1185 g. Median estimated graft volume was 927.5 ml, averaged 944.86±200.74 ml and ranged from 600-1477 ml. Linear regression of estimated graft volume and actual GW was significantly linear (GW=0.82 estimated graft volume, r2=0.98, slope=0.47, standard deviation of 0.024 and p<0.0001). Spearman Linear correlation was 0.65 with 95% CI of 0.45 - 0.99 (p<0.0001).

CONCLUSION

The one-to-one rule did not applied in patients with normal liver parenchyma. A better estimation of graft weight could be reached by multiplying estimated graft volume by 0.82.

摘要

背景

计算机断层扫描体积测量法（CTV）是预测活体肝移植（LDLT）供肝重量（GW）的有用工具。很少有研究探讨正常肝实质中CTV与GW之间的相关性。

目的

分析成人LDLT人群中CTV与GW之间的相关性，并对现有的计算部分肝移植重量的数学模型进行系统评价。

方法

回顾性分析2009年1月至2013年1月期间连续28例接受LDLT右半肝切除术的供体。所有移植物均用HTK溶液灌注。通过CTV估算移植物体积，并将这些值与实际移植物重量进行比较，实际移植物重量在肝脏切取和灌注后测量。

结果

实际GW中位数为782.5 g，平均为791.43±136 g，范围为520 - 1185 g。估计移植物体积中位数为927.5 ml，平均为944.86±200.74 ml，范围为600 - 1477 ml。估计移植物体积与实际GW的线性回归具有显著线性（GW = 0.82×估计移植物体积，r2 = 0.98，斜率 = 0.47，标准差为0.024，p < 0.0001）。Spearman线性相关性为0.65，95%可信区间为0.45 - 0.99（p < 0.0001）。