Factors Influencing Liver and Spleen Volume Changes after Donor Hepatectomy for Living Donor Liver Transplantation

Abstract

Purpose: To define the changes in liver and spleen volumes in the early postoperative period after partial liver donation for living-donor liver transplantation (LDLT) and to determine factors that influence liver and spleen volume changes. Materials and Methods: 27 donors who underwent partial hepatectomy for LDLT were included in this study. The rates of liver and spleen volume change, measured with CT volumetry, were correlated with several factors. The analyzed factors included the indocyanine green (ICG) retention rate at 15 minutes after ICG administration, preoperative platelet count, preoperative liver and splenic volumes, resected liver volume, resected-to-whole liver volume ratio (LVR/LVW), resected liver volume to the sum of whole liver and spleen volume ratio [LVR/(LVW + SV0)], and pre and post hepatectomy portal venous pressures. Results: In all hepatectomy donors, the volumes of the remnant liver and spleen were increased (increased rates, 59.5 ± 50.5%, 47.9 ± 22.6%). The increment rate of the remnant liver volume revealed a positive correlation with LVR/LVW (r = 0.759, p < 0.01). The other analyzed factors showed no correlation with changes in liver and spleen volumes. Conclusion: The spleen and remnant liver volumes were increased at CT volumetry performed 2 weeks after partial liver donation. Among the various analyzed factors, LVR/LVW influences the increment rate of the remnant liver volume. Index terms Hepatectomy Transplantation Liver Spleen