Ann Surg Treat Res.  2017 Apr;92(4):214-220. 10.4174/astr.2017.92.4.214.

The correlation between preoperative volumetry and real graft weight: comparison of two volumetry programs

• Mussin N
• Sumo M
• Lee KW
• Choi Y
• Choi JY
• Ahn SW
• Yoon KC
• Kim HS
• Hong SK
• Yi NJ
• Suh KS

• KMID: 2374687
• DOI: http://doi.org/10.4174/astr.2017.92.4.214

Abstract

PURPOSE
Liver volumetry is a vital component in living donor liver transplantation to determine an adequate graft volume that meets the metabolic demands of the recipient and at the same time ensures donor safety. Most institutions use preoperative contrast-enhanced CT image-based software programs to estimate graft volume. The objective of this study was to evaluate the accuracy of 2 liver volumetry programs (Rapidia vs. Dr. Liver) in preoperative right liver graft estimation compared with real graft weight.
METHODS
Data from 215 consecutive right lobe living donors between October 2013 and August 2015 were retrospectively reviewed. One hundred seven patients were enrolled in Rapidia group and 108 patients were included in the Dr. Liver group. Estimated graft volumes generated by both software programs were compared with real graft weight measured during surgery, and further classified into minimal difference (≤15%) and big difference (>15%). Correlation coefficients and degree of difference were determined. Linear regressions were calculated and results depicted as scatterplots.
RESULTS
Minimal difference was observed in 69.4% of cases from Dr. Liver group and big difference was seen in 44.9% of cases from Rapidia group (P = 0.035). Linear regression analysis showed positive correlation in both groups (P < 0.01). However, the correlation coefficient was better for the Dr. Liver group (R² = 0.719), than for the Rapidia group (R² = 0.688).
CONCLUSION
Dr. Liver can accurately predict right liver graft size better and faster than Rapidia, and can facilitate preoperative planning in living donor liver transplantation.

Keyword

Living donors; Organ size; Donor selection

MeSH Terms

Donor Selection
Humans
Linear Models
Liver
Liver Transplantation
Living Donors
Organ Size
Retrospective Studies
Tissue Donors
Tomography, X-Ray Computed
Transplants*

Figure

• 

  Fig. 1 Correlation between preoperative and real graft weight using the 2 programs. Scatterplot diagrams show a positive linear correlation for preoperative volume (Volumetry) and real graft weight (Graft Weight) determinations in Rapidia (A) and Dr. Liver (B). The correlation coefficient was better in the Dr. Liver group (R2 = 0.688 vs. R2 = 0.719). Rapidia software (Infinitt Co., Ltd., Seoul, Korea); Dr. Liver software (Virtual Liver Surgery Planning System, Humanopia Co. Ltd, Pohang, Korea).

• 

  Fig. 2 Difference in liver extraction process between Rapidia and Dr. Liver for normal and fatty liver. (A, B) Parenchyma of normal and fatty liver at same threshold range 83–150 (Rapidia). (C) Fatty liver at an adjusted threshold range 50–1,000 (Rapidia) to include most of parenchyma. (D, E) Parenchyma of normal and fatty liver (Dr. Liver) not dependent on attenuation/thresholding adjustments. Rapidia software (Infinitt Co., Ltd., Seoul, Korea); Dr. Liver software (Virtual Liver Surgery Planning System, Humanopia Co. Ltd, Pohang, Korea).

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