Korean J Transplant.  2022 Nov;36(Supple 1):S22. 10.4285/ATW2022.F-1171.

Preoperative skeletal muscle index is associated with early remnant liver regeneration in living donors after right hemihepatectomy for liver transplantation

• Lee S
• Kim KW

• KMID: 2535170
• DOI: http://doi.org/10.4285/ATW2022.F-1171

Abstract

Background
We aimed to investigate the correlation between preoperative skeletal muscle index (SMI) and remnant liver regen-eration after right hemihepatectomy for living donor liver transplantation, and to determine the preoperative factors predictive of greater remnant liver regeneration in living donors.
Methods
This retrospective study included 525 right hemiliver donors (mean age, 28.9±8.3 years; 345 males) between 2017 and 2018, who underwent computed tomography (CT) before surgery and on postoperative day (POD) 7. Preoperative an-thropometry, laboratory parameters, skeletal muscle area at the third lumbar vertebral level, and liver volume before and after surgery were evaluated. Correlations were analyzed using Pearson’s correlation coefficient, and stepwise multiple regression analysis was used to identify independent predictors of greater remnant liver regeneration.
Results
Remnant liver regeneration volume on POD 7 was positively correlated with body mass index (BMI) (r=0.280, P<0.001) and SMI (r=0.322, P<0.001), and negatively correlated with age (r=–0.154, P<0.001) and future remnant liver volume (FRLV)/total liver volume (TLV) ratio (r=–0.261, P<0.001). Stepwise multiple regression analysis showed that high BMI (r=0.146, P=0.001) and SMI (r=0.228, P<0.001) and low age (r=–0.091, P=0.025) and FRLV/TLV ratio (r=–0.225, P<0.001) were predictors of greater rem-nant liver regeneration.
Conclusions
High SMI as well as high BMI, low age, and low FRLV/TLV ratio may be predictors of greater early remnant liver re-generation after LDLT in living donors.