1. Utilidad de la volumetría hepática semiautomática por tomografía computada para la estimación preoperatoria del peso del injerto previo a trasplante con donante vivo. Experiencia cooperativa.
- Author
-
García, Daniel, Sotomayor, Camila, San Martín, Rodrigo, Rebolledo, Patricia, Domínguez, Pilar, Achurra, Pablo, Viñuela, Eduardo, Briceño, Eduardo, Jarufe, Nicolás, Martínez, Jorge, and Dib, Martin
- Abstract
Introduction: Living donor liver transplantation (LDLT) is a surgical technique developed with the aim of addressing the low donation rate. Living donor selection is crucial to minimize donor risks and maximize recipient outcomes. Computer tomographic right liver volumetry (CTRLV) is one of the most important steps when planning a living donor right hepatectomy. Methods: Retrospective study of all patients who underwent right lobectomy for living donor liver transplantation at Red de Salud UC-CHRISTUS, between January 2016 and December 2021. CTRLV and corrected CTRLV (CTRLVc) were compared with graft weight by calculating the mean difference, using Paired sample t-test, the calculation of the Pearson’s correlation coefficient to evaluate its linear correlation and the performance of the Bland-Altman (BA) test and the calculation of the intraclass correlation coefficient (ICC) to evaluate The concordance. Objectives: The principal aim is to determine the correlation and concordance between a semiautomatic method for estimating CTRLV and the weight of the liver graft in adult-to-adult living donor hepatectomy. As a secondary objective, we aimed to assess the concordance and correlation of a semiautomatic method for estimating CTRLV between two independent observers. Results: 41 patients underwent right lobectomy for living donor liver transplantation, among these, 36 had preoperative CT right liver volumetry. The mean CTRLV and CTRLVc were 902.7 ± 162 cc and 739.9 ± 132.8 cc, respectively. The graft weight (GW) average was 773.8 ± 126.9 cc. The average of the CTRLV was significantly higher than the GW (16.7% overestimation. The mean CTRLVc was still different than mean graft weight (4.4% underestimation). There was a direct linear correlation between the computer tomographic volumetry (CTV) and the GW when calculating Pearson’s correlation coefficient (r = 0.796; p < 0.001). When calculating average GBWR with the estimated graft weight according to CT volumetry, it was 1.27. When recalculating this value, but with the actual graft weight (measured during surgery), the average GBWR was 1.05, considered safe in LDLT. Conclusions: The calculation of the CTRLV with a correction factor has a good correlation and concordance with the graft weight obtained after a right lobectomy for living donor liver transplantation. [ABSTRACT FROM AUTHOR]
- Published
- 2025
- Full Text
- View/download PDF