Details

Autor(en) / Beteiligte

• Mohapatra, Nihar
• Sinha, Piyush Kumar
• Sasturkar, Shridhar Vasantrao
• Patidar, Yashwant
• Pamecha, Viniyendra

Titel

Preoperative Alanine Aminotransferase and Remnant Liver Volume Predict Liver Regeneration After Live Donor Hepatectomy

Ist Teil von

• Journal of gastrointestinal surgery, 2020-08, Vol.24 (8), p.1818-1826

Ort / Verlag

New York: Springer US

Erscheinungsjahr

2020

Quelle

MEDLINE

Beschreibungen/Notizen

• Background Regeneration of the remnant liver in early postoperative period determines the outcome in live liver donors (LLDs). The aim of the current study is to evaluate the factors that influence liver regeneration following live donor hepatectomy. Methods Total liver volume (TLV), estimated graft volume (EGV), and remnant liver volume (RLV) were calculated preoperatively in a prospective study of 154 LLDs. Absolute and percentage growth of remnant liver (regeneration index) in donor was estimated at 7th postoperative day (POD) by computed tomography (CT) volumetric analysis. Results One hundred eighteen donors underwent right hepatectomy (RH), 29 underwent left hepatectomy (LH), 6 donors had left lateral sectionectomy (LLS), and one had right posterior sectionectomy. The median percentage growth of remnant liver at the end of the first week was 46.14% (51.74%, 35.32%, and 17.38% for RH, LH, and LLS, respectively). On univariate analysis, female donors ( p  = 0.051), RH graft ( p  = 0.001), no steatosis on ultrasonography ( p  = 0.042), lower TLV ( p  = 0.029), RLV ( p  = < 0.001), RLV-to-body weight ratio (RLVBWR) ( p  = < 0.001), preoperative alanine aminotransferase (ALT) level ( p  = 0.017), aspartate aminotransferase (AST) ( p  = 0.035) and higher POD 7 alkaline phosphatase (ALP) ( p  = 0.033), and POD 7 gamma-glutamyl transferase GGT ( p  = 0.006) were found to be predictors of greater liver regeneration. Among them, lower RLV ( P  = 0.008), RLVBWR ( p  = 0.011), and preoperative ALT level ( p  = 0.021) were most significant factors predictive of liver regeneration on logistic regression analysis with backward elimination. Conclusion The liver regenerates rapidly in LLDs following hepatectomy. Low RLV, RLVBWR, and preoperative ALT levels were predictors of liver regeneration in the first week following donor hepatectomy.