Ann Liver Transplant.  2022 May;2(1):28-33. 10.52604/alt.22.0014.

Comparison of skeletal muscle index and body surface area-based formulae for estimation of standard liver volume

• Ageel AH
• Park JI
• Chung YK
• Jung DH
• Hwang S

• KMID: 2560878
• DOI: http://doi.org/10.52604/alt.22.0014

Abstract

Background
Formula-derived standard liver volume (SLV) has been clinically used for living donor liver transplantation and hepatic resection. The majority of currently available SLV formulae are based on the body surface area (BSA). However, they often show a wide range of error. Skeletal muscle index measured at the third lumbar vertebra level (L3SMI) appears to reflect the lean body mass. The objective of this study was to compare the accuracy of L3SMI-based formula and BSA-based formula for calculating SLV.
Methods
The study cohort included 100 living liver donors who underwent surgery between January 2020 and December 2020. Computed tomography images were used for liver volumetry and skeletal muscle area measurement.
Results
The study cohort included 62 male and 38 female donors. Their age, BSA, L3SMI, and body mass index were 35.6±6.9 years, 1.79±0.19 m² , 51.9±9.6 cm² /m² , and 23.3±3.1 kg/m² , respectively. The L3SMI-based SLV formula was as follows: SLV (mL)=19.7×L3SMI (cm² /m² ) +428.4 (R 2 =0.375, p<0.001). The BSA-based SLV formula was as follows: SLV (mL)=1,021.7×BSA (m 2 ) —372.9 (R 2 =0.415, p<0.001). The mean difference from the actual total liver volume (TLV) was —2.7%±17.4% and 2.6%±16.5% for the L3SMI- and BSA-based formulae, respectively. A formula for the arithmetic mean of L3SMI- and BSA-based formulae was as follows: SLV (mL)=510.9×BSA (m² ) +9.9×L3SMI (cm² /m² ) +27.8”, with a mean difference of —2.6%±15.9% from the actual TLV.
Conclusion
The results of this study suggest that the reliability of SLV calculation with the L3SMI-based formula was not superior to that of SLV calculation with the BSA-based formula. The formula of SLV calculation using both BSA and L3SMI seems to deserve further validation studies.

Keyword

Standard liver volume; Body surface area; Skeletal muscle index; Body mass index; Liver transplantation