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基于三维容积测量法预测活体肝供体体重变化时移植肝重量的多变量线性模型:一项观察性队列研究。

Multivariable linear model for predicting graft weight based on 3-dimensional volumetry in regards to body weight change of living liver donor: an observational cohort study.

作者信息

Han Seungwook, Rhu Jinsoo, Lim Soyoung, Choi Gyu-Seong, Kim Jong Man, Joh Jae-Won

机构信息

Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Ann Surg Treat Res. 2024 Aug;107(2):91-99. doi: 10.4174/astr.2024.107.2.91. Epub 2024 Jul 30.

Abstract

PURPOSE

The purpose of this study is to build a prediction model for estimating graft weight about different graft volumetry methods combined with other variables.

METHODS

Donors who underwent living-donor right hepatectomy from March 2021 to March 2023 were included. Estimated graft volume measured by conventional method and 3-dimensional (3D) software were collected as well as the actual graft weight. Linear regression was used to build a prediction model. Donor groups were divided according to the 3D volumetry of <700 cm, 700-899 cm, and ≥900 cm to compare the performance of different models.

RESULTS

A total of 119 donors were included. Conventional volumetry showed R of 0.656 (P < 0.001) while 3D software showed R of 0.776 (P < 0.001). The R of the multivariable model was 0.842 (P < 0.001) including for 3D volume (β = 0.623, P < 0.001), body mass index (β = 7.648, P < 0.001), and amount of weight loss (β = -7.252, P < 0.001). The median errors between different models and actual graft weight did not differ in donor groups (<700 and 700-899 cm), while the median error of univariable linear model using 3D software (122.5; interquartile range [IQR], 61.5-179.8) was significantly higher than multivariable-adjusted linear model (41.5; IQR, 24.8-69.8; P = 0.003) in donors with estimated graft weight ≥900 cm.

CONCLUSION

The univariable 3D volumetry model showed an acceptable outcome for donors with an estimated graft volume <900 cm. For donors with an estimated graft volume ≥900 cm, the multivariable-adjusted linear model showed higher accuracy.

摘要

目的

本研究旨在构建一个预测模型,用于结合其他变量估算不同移植物容积测量方法下的移植物重量。

方法

纳入2021年3月至2023年3月期间接受活体右半肝切除术的供体。收集通过传统方法和三维(3D)软件测量的估计移植物容积以及实际移植物重量。采用线性回归构建预测模型。根据3D容积将供体组分为<700 cm、700 - 899 cm和≥900 cm,以比较不同模型的性能。

结果

共纳入119例供体。传统容积测量法的R值为0.656(P < 0.001),而3D软件的R值为0.776(P < 0.001)。多变量模型的R值为0.842(P < 0.001),包括3D容积(β = 0.623,P < 0.001)、体重指数(β = 7.648,P < 0.001)和体重减轻量(β = -7.252,P < 0.001)。不同模型与实际移植物重量之间的中位数误差在<700 cm和700 - 899 cm的供体组中无差异,而在估计移植物重量≥900 cm的供体中,使用3D软件的单变量线性模型的中位数误差(122.5;四分位数间距[IQR],61.5 - 179.8)显著高于多变量调整线性模型(41.5;IQR,24.8 - 69.8;P = 0.003)。

结论

对于估计移植物容积<900 cm的供体,单变量3D容积模型显示出可接受的结果。对于估计移植物容积≥900 cm的供体,多变量调整线性模型显示出更高的准确性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5612/11317358/43495356157c/astr-107-91-g001.jpg

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