Seleem Mohamed Ismail, Salaam Mohamed Adel, Abd El Hamid Nader Mohamed
Department of Hepatobiliary and Liver Transplantation, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt.
Department of Hepatobiliary and Liver Transplantation, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt.
Transplant Proc. 2020 Apr;52(3):894-899. doi: 10.1016/j.transproceed.2019.12.042. Epub 2020 Mar 19.
Computed tomography (CT) volumetry and magnetic resonance cholangiopancreatography (MRCP) are mandatory steps for the evaluation of potential donors in living donor liver transplantation. The aim of this study is to compare the preoperative CT volumetry and biliary orifices of the donor graft to the actual operative findings.
Between December 2013 and December 2017, 45 donors (27 men and 18 women) with a mean age of 27.3 years (range, 19-41 years) were evaluated preoperatively by CT volumetry and MRCP at the National Hepatology and Tropical Medicine Research Institute in Cairo, Egypt. Of the donors, 43 out of 45 underwent intraoperative cholangiography before and after bile duct division. The right hepatectomies for all donors, as well as the actual weight and apparent biliary orifices in the graft, were documented.
The mean estimated graft volume (EGV) preoperatively by CT volumetry was 894.9 ± 184.2 mL (range, 480-1687 mL), whereas the actual graft weight (AGW) intraoperatively after washout was 862.6 ± 124.4 g (range, 676-1110 g). The correlation coefficient between the EGV and AGW was significantly linear (Y = 0.96X, r = 0.72, slope: 0.96, P < .001). The accuracy of the MRCP in preoperative biliary mapping was 76.7% whereas the accuracy of the MRCP in predicting the number of graft biliary orifices was 74.4% compared with the intraoperative cholangiography (IOC), which was 95.3% (P < .001).
The weight of the right lobe of the liver graft in living donor liver transplants (LDLTs) can be accurately predicted preoperatively by multiplying the EGV by 0.96. Also, the IOC is an essential technique for LDLT.
计算机断层扫描（CT）容积测量和磁共振胰胆管造影（MRCP）是活体肝移植潜在供体评估的必要步骤。本研究的目的是比较供体移植物术前CT容积测量和胆管开口与实际手术结果。
2013年12月至2017年12月期间，埃及开罗国家肝病和热带医学研究所对45名供体（27名男性和18名女性）进行了术前CT容积测量和MRCP评估，平均年龄27.3岁（范围19 - 41岁）。45名供体中有43名在胆管离断前后进行了术中胆管造影。记录了所有供体的右半肝切除术情况，以及移植物的实际重量和明显的胆管开口。
术前CT容积测量的平均估计移植物体积（EGV）为894.9±184.2 mL（范围480 - 1687 mL），而冲洗后术中实际移植物重量（AGW）为862.6±124.4 g（范围676 - 1110 g）。EGV与AGW之间的相关系数呈显著线性关系（Y = 0.96X，r = 0.72，斜率：0.96，P <.001）。与术中胆管造影（IOC）相比，MRCP术前胆管造影的准确率为76.7%，而MRCP预测移植物胆管开口数量的准确率为74.4%，IOC的准确率为95.3%（P <.001）。
活体肝移植（LDLT）中肝移植物右叶的重量可通过将EGV乘以0.96进行术前准确预测。此外，IOC是LDLT的一项重要技术。
