Department of Surgery, The University of Hong Kong, Hong Kong, China.
State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong, China.
Liver Transpl. 2017 Sep;23(9):1113-1122. doi: 10.1002/lt.24807.
The objective of this article is to derive a more accurate and easy-to-use formula for finding estimated standard liver volume (ESLV) using novel computed tomography (CT) measurement parameters. New formulas for ESLV have been emerging that aim to improve the accuracy of estimation. However, many of these formulas contain body surface area measurements and logarithms in the equations that lead to a more complicated calculation. In addition, substantial errors in ESLV using these old formulas have been shown. An improved version of the formula for ESLV is needed. This is a retrospective cohort of consecutive living donor liver transplantations from 2005 to 2016. Donors were randomly assigned to either the formula derivation or validation groups. Total liver volume (TLV) measured by CT was used as the reference for a linear regression analysis against various patient factors. The derived formula was compared with the existing formulas. There were 722 patients (197 from the derivation group, 164 from the validation group, and 361 from the recipient group) involved in the study. The donor's body weight (odds ratio [OR], 10.42; 95% confidence interval [CI], 7.25-13.60; P < 0.01) and body thickness (OR, 2.00; 95% CI, 0.36-3.65; P = 0.02) were found to be independent factors for the TLV calculation. A formula for TLV (cm ) was derived: 2 × thickness (mm) + 10 × weight (kg) + 190 with R 0.48, which was the highest when compared with the 4 other most often cited formulas. This formula remained superior to other published formulas in the validation set analysis (R , 5.37; interclass correlation coefficient, 0.74). Graft weight/ESLV values calculated by the new formula were shown to have the highest correlation with delayed graft function (C-statistic, 0.79; 95% CI, 0.69-0.90; P < 0.01). The new formula (2 × thickness + 10 × weight + 190) represents the first study proposing the use of CT-measured body thickness which is novel, easy to use, and the most accurate for ESLV. Liver Transplantation 23 1113-1122 2017 AASLD.
本文旨在推导出一种更准确、更易用的公式，用于通过新型计算机断层扫描（CT）测量参数计算估计标准肝体积（ESLV）。新的 ESLV 公式不断涌现，旨在提高估计的准确性。然而，这些公式中的许多公式在方程中包含了体表面积测量和对数，导致计算更加复杂。此外，使用这些旧公式计算 ESLV 会产生大量误差。需要改进 ESLV 的公式。这是一项回顾性队列研究，纳入了 2005 年至 2016 年连续进行的活体供肝移植患者。供者随机分配到公式推导组或验证组。使用 CT 测量的总肝体积（TLV）作为参考，进行线性回归分析，以评估各种患者因素。将推导的公式与现有的公式进行比较。共有 722 例患者（推导组 197 例，验证组 164 例，受体组 361 例）参与了本研究。研究发现，供者的体重（比值比[OR]，10.42；95%置信区间[CI]，7.25-13.60；P < 0.01）和体厚（OR，2.00；95%CI，0.36-3.65；P = 0.02）是 TLV 计算的独立因素。推导出了一个 TLV（cm）公式：2×厚度（mm）+10×体重（kg）+190，R 0.48，与其他 4 个常被引用的公式相比，该公式的 R 值最高。在验证组分析中，该公式仍优于其他已发表的公式（R 0.57；组内相关系数，0.74）。新公式计算的移植物重量/ESLV 值与延迟移植物功能（C 统计量，0.79；95%CI，0.69-0.90；P < 0.01）相关性最高。新公式（2×厚度+10×体重+190）代表第一项提出使用 CT 测量体厚的研究，该公式新颖、易用，是计算 ESLV 最准确的公式。肝移植 23 1113-1122 2017 AASLD。
