Korean J Transplant.  2023 Nov;37(Suppl 1):S111. 10.4285/ATW2023.F-6900.

Factors influencing liver regeneration after living donor hepatectomy: a retrospective study in a small-volume center

• Kim M
• Kim TS
• Ahn KS
• Kim YH
• Kang KJ

• KMID: 2551731
• DOI: http://doi.org/10.4285/ATW2023.F-6900

Abstract

Background: Liver transplantation (LT) is a life-saving procedure for patients with end-stage liver disease. Living donor LT (LDLT) has emerged as a viable alternative to deceased donor transplantation, due in part to the livers unique ability to regenerate. For many years, understanding the extent of liver regeneration has been deemed crucial for the safety of living donors and the effectiveness of the transplantation process. This study aimed to delve deeper into liver regeneration following LDLT and evaluate the impact of various factors on this process.
Methods
A retrospective analysis was conducted on 66 patients who underwent LDLT at Keimyung University Dongsan Medical Center, Daegu, Korea, from 2005 to 2022. Liver volume changes were monitored through computed tomography imaging for 1 year postsurgery. Factors such as age, sex, and presence of fatty changes were examined for their impact on liver regeneration.
Results
Our findings suggest that the liver regenerates maximally within 6 weeks post-LDLT, beyond which the liver volume remains relatively constant. Age, sex, and the presence of fatty changes did not significantly impact the liver regeneration rate (age: r=–0.086, P=0.536; sex: P=0.9927; fatty changes: micro P=0.267, macro P=0.243). However, the estimated remnant volume was found to be a significant determinant of the liver regeneration rate (r=–0.583, P<0.00001). On long-term follow-up, regardless of the different factors, the liver volume grew to approximately 83% of the preoperative whole liver volume.
Conclusions
The study sheds light on the complex process of liver regeneration following LDLT. These findings contribute to refining surgical techniques, postoperative care strategies, and the selection process for living donors, thereby improving the outcomes of living donor hepatectomy and ensuring donor safety.