Pietro Addeo1,2, Benoit Naegel3, Pierre De Mathelin4, Chloe Paul4, François Faitot4,3, Caroline Schaaf4, Alfonso Terrone4, Lawrence Serfaty5, Philippe Bachellier4, Vincent Noblet3. 1. Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, 1, Avenue Moliere, 67098, Strasbourg, France. pietrofrancesco.addeo@chru-strasbourg.fr. 2. ICube, Université de Strasbourg, CNRS UMR 7357, Illkirch, France. pietrofrancesco.addeo@chru-strasbourg.fr. 3. ICube, Université de Strasbourg, CNRS UMR 7357, Illkirch, France. 4. Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, 1, Avenue Moliere, 67098, Strasbourg, France. 5. Hepatology Department, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France.
Abstract
BACKGROUND: Anthropometric parameters (weight, height) are usually used for quick matching between two individuals (donor and recipient) in liver transplantation (LT). This study aimed to evaluate clinical factors influencing the overall available space for implanting a liver graft in cirrhotic patients. METHODS: In a cohort of 275 cirrhotic patients undergoing LT, we calculated the liver volume (LV), cavity volume (CV), which is considered the additional space between the liver and the right hypocondrium, and the overall volume (OV = LV + CV) using a computed tomography (CT)-based volumetric system. We then chose the formula based on anthropometric parameters that showed the best predictive value for LV. This formula was used to predict the OV in the same population. Factors influencing OV variations were identified by multivariable logistic analysis. RESULTS: The Hashimoto formula (961.3 × BSA_D-404.8) yielded the lowest median absolute percentage error (21.7%) in predicting the LV. The median LV was 1531 ml. One-hundred eighty-five patients (67.2%) had a median CV of 1156 ml (range: 70-7006), and the median OV was 2240 ml (range: 592-8537). Forty-nine patients (17%) had an OV lower than that predicted by the Hashimoto formula. Independent factors influencing the OV included the number of portosystemic shunts, right anteroposterior abdominal diameter, model for end-stage liver disease (MELD) score > 25, high albumin value, and BMI > 30. CONCLUSIONS: Additional anthropometric characteristics (right anteroposterior diameter, body mass index) clinical (number of portosystemic shunts), and biological (MELD, albumin) factors might influence the overall volume available for liver graft implantation. Knowledge of these factors might be helpful during the donor-recipient matching.
BACKGROUND: Anthropometric parameters (weight, height) are usually used for quick matching between two individuals (donor and recipient) in liver transplantation (LT). This study aimed to evaluate clinical factors influencing the overall available space for implanting a liver graft in cirrhotic patients. METHODS: In a cohort of 275 cirrhotic patients undergoing LT, we calculated the liver volume (LV), cavity volume (CV), which is considered the additional space between the liver and the right hypocondrium, and the overall volume (OV = LV + CV) using a computed tomography (CT)-based volumetric system. We then chose the formula based on anthropometric parameters that showed the best predictive value for LV. This formula was used to predict the OV in the same population. Factors influencing OV variations were identified by multivariable logistic analysis. RESULTS: The Hashimoto formula (961.3 × BSA_D-404.8) yielded the lowest median absolute percentage error (21.7%) in predicting the LV. The median LV was 1531 ml. One-hundred eighty-five patients (67.2%) had a median CV of 1156 ml (range: 70-7006), and the median OV was 2240 ml (range: 592-8537). Forty-nine patients (17%) had an OV lower than that predicted by the Hashimoto formula. Independent factors influencing the OV included the number of portosystemic shunts, right anteroposterior abdominal diameter, model for end-stage liver disease (MELD) score > 25, high albumin value, and BMI > 30. CONCLUSIONS: Additional anthropometric characteristics (right anteroposterior diameter, body mass index) clinical (number of portosystemic shunts), and biological (MELD, albumin) factors might influence the overall volume available for liver graft implantation. Knowledge of these factors might be helpful during the donor-recipient matching.
Entities:
Keywords:
Anthropometrics; Ascites; Body mass index; Donor; Liver transplantation; Liver volume; Liver weight; Portal hypertension; Portosystemic shunts; Recipient matching; Right anteroposterior diameter
Authors: Pietro Addeo; Benoit Naegel; Alfonso Terrone; François Faitot; Caroline Schaaf; Philippe Bachellier; Vincent Noblet Journal: Liver Int Date: 2021-03-01 Impact factor: 5.828
Authors: Michael Linecker; Florin Botea; Dimitri Aristotele Raptis; Diana Nicolaescu; Përparim Limani; Ruslan Alikhanov; Pavel Kim; Andrea Wirsching; Philipp Kron; Marcel A Schneider; Christoph Tschuor; Patryk Kambakamba; Christian Oberkofler; Michelle L De Oliveira; John Bonvini; Michail Efanov; Rolf Graf; Henrik Petrowsky; Igor Khatkov; Pierre-Alain Clavien; Irinel Popescu Journal: J Hepatol Date: 2019-10-15 Impact factor: 25.083