Urata K, Kawasaki S, Matsunami H, Hashikura Y, Ikegami T, Ishizone S, Momose Y, Komiyama A, Makuuchi M
First Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Hepatology. 1995 May;21(5):1317-21.
Despite refinements in surgical techniques for liver transplantation, liver size disparity remains one of the most common problems in pediatric patients. Optimal liver graft size remains unknown and the volume of diseased liver in the recipient is not indicative of the volume (standard liver volume [LV]) optimal for the recipient's metabolic demands. To establish a formula for calculating the standard LV in the pediatric and adult populations for liver transplantation, whole LVs were measured using computed tomography (CT) in 96 patients (65 pediatric and 31 adolescent or adult subjects) with normal liver whose disease conditions did not seem to affect body weight (BW) or LV. In the 96 subjects, the ratio of estimated LV to BW decreased gradually as age increased until approximately 16 years, when it started to level off. On the other hand, there seemed to be a directly proportional relationship between the estimated LV in vivo and body surface area (BSA) (r = .981; r2 = .962; P < .0001) in the subjects as a whole, and the formula, LV (mL) = 706.2 x BSA (m2) + 2.4, was established from the measured data by simple regression analysis. Another predicting equation, LV (mL) = 2.223 x BW (kg)0.426 x body height (BH) (cm)0.682, was produced by multiple regression analysis (r2 = .969; P < .0001). Considering its simplicity of use, we adopted the first formula for predicting standard LV in an individual patient.
尽管肝移植手术技术有所改进，但肝大小差异仍是儿科患者中最常见的问题之一。最佳肝移植大小仍不明确，且受体中病肝的体积并不能表明满足受体代谢需求的最佳体积（标准肝体积[LV]）。为了建立用于计算儿科和成人肝移植患者标准LV的公式，我们对96例肝脏正常且疾病状况似乎不影响体重（BW）或LV的患者（65例儿科患者以及31例青少年或成人受试者）进行了计算机断层扫描（CT）以测量全肝体积。在这96名受试者中，估计的LV与BW的比值随着年龄的增长逐渐下降，直到约16岁时开始趋于平稳。另一方面，总体而言，受试者体内估计的LV与体表面积（BSA）之间似乎存在直接的比例关系（r = 0.981；r2 = 0.962；P < 0.0001），并且通过简单回归分析从测量数据中建立了公式LV（mL）= 706.2×BSA（m2）+ 2.4。通过多元回归分析得出了另一个预测方程LV（mL）= 2.223×BW（kg）0.426×身高（BH）（cm）0.682（r2 = 0.969；P < 0.0001）。考虑到其使用的简便性，我们采用第一个公式来预测个体患者的标准LV。
