Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, 1, Avenue Moliere, 67098, Strasbourg, France.
ICube, Université de Strasbourg, CNRS UMR 7357, Illkirch, France.
Hepatol Int. 2021 Jun;15(3):780-790. doi: 10.1007/s12072-021-10187-6. Epub 2021 Apr 13.
Anthropometric parameters (weight, height) are usually used for quick matching between two individuals (donor and recipient) in liver transplantation (LT). This study aimed to evaluate clinical factors influencing the overall available space for implanting a liver graft in cirrhotic patients.
In a cohort of 275 cirrhotic patients undergoing LT, we calculated the liver volume (LV), cavity volume (CV), which is considered the additional space between the liver and the right hypocondrium, and the overall volume (OV = LV + CV) using a computed tomography (CT)-based volumetric system. We then chose the formula based on anthropometric parameters that showed the best predictive value for LV. This formula was used to predict the OV in the same population. Factors influencing OV variations were identified by multivariable logistic analysis.
The Hashimoto formula (961.3 × BSA_D-404.8) yielded the lowest median absolute percentage error (21.7%) in predicting the LV. The median LV was 1531 ml. One-hundred eighty-five patients (67.2%) had a median CV of 1156 ml (range: 70-7006), and the median OV was 2240 ml (range: 592-8537). Forty-nine patients (17%) had an OV lower than that predicted by the Hashimoto formula. Independent factors influencing the OV included the number of portosystemic shunts, right anteroposterior abdominal diameter, model for end-stage liver disease (MELD) score > 25, high albumin value, and BMI > 30.
Additional anthropometric characteristics (right anteroposterior diameter, body mass index) clinical (number of portosystemic shunts), and biological (MELD, albumin) factors might influence the overall volume available for liver graft implantation. Knowledge of these factors might be helpful during the donor-recipient matching.
在肝移植（LT）中，通常使用人体测量参数（体重、身高）来快速匹配供体和受体。本研究旨在评估影响肝硬化患者肝移植中肝移植整体可用空间的临床因素。
在 275 例接受 LT 的肝硬化患者队列中，我们使用基于计算机断层扫描（CT）的体积系统计算了肝体积（LV）、腔体积（CV），这被认为是肝与右肋缘之间的额外空间，以及整体体积（OV=LV+CV）。然后，我们选择了基于人体测量参数的公式，该公式对 LV 具有最佳预测值。该公式用于预测同一人群的 OV。通过多变量逻辑分析确定影响 OV 变化的因素。
Hashimoto 公式（961.3×BSA_D-404.8）在预测 LV 时产生的中位数绝对百分比误差（21.7%）最低。LV 的中位数为 1531ml。185 例患者（67.2%）CV 中位数为 1156ml（范围：70-7006），OV 中位数为 2240ml（范围：592-8537）。49 例患者（17%）的 OV 低于 Hashimoto 公式预测值。影响 OV 的独立因素包括门体分流的数量、右前-后腹直径、终末期肝病模型（MELD）评分>25、高白蛋白值和 BMI>30。
其他人体测量特征（右前-后直径、体重指数）、临床（门体分流的数量）和生物学（MELD、白蛋白）因素可能影响肝移植整体可用空间。了解这些因素可能有助于供体-受体匹配。
