Mustafa ÖZDEMİR, Halil ÖZER, Yiğit DÜZKÖYLÜ, Rıza Sarper ÖKTEN, Fatma Ayça Edis ÖZDEMİR

Canlı vericili karaciğer transplantasyonu öncesi intraoperatif olarak ölçülen greft ağırlığının tahmininde bilgisayarlı tomografinin rolü

Giriş ve Amaç: Bu çalışmanın amacı canlıdan karaciğer transplantasyonunda greftin değerlendirilmesinde bilgisayarlı tomografi ile ölçülen tahmini greft volümünden korreksiyon faktörü kullanılarak hesaplanan tahmini greft ağırlığı ile gerçek greft ağırlığının karşılaştırılması ve bu korreksiyon faktörünün efektivitesinin araştırılmasıdır. Gereç ve Yöntem: Ocak 2009-Temmuz 2015 tarihleri arasında 42 canlı karaciğer donörünün (20 kadın, 22 erkek; ortalama yaş, 42.23 yıl±17.25 (18-52) dinamik kontrastlı hepatik bilgisayarlı tomografi kesitlerinden elde edilen veriler retrospektif olarak tarandı. Donörler, karaciğer nakli için karaciğer sağ lob rezeksiyonu yapılan sağlıklı erişkinlerdi. Bilgisayarlı tomografi ile ölçülen tahmini greft volümü (cc) Lemke ve arkadaşlarının formülü (tahmini greft ağırlığı (g): 0.678 x tahmini greft volümü (cc) +143.704 g) kullanılarak tahmin edildi. Tahmini greft ağırlığı ile gerçek greft ağırlığı arasındaki ilişkiyi saptamak için Pearson korelasyon testi kullanıldı. Bulgular: Ameliyat öncesi ortalama karaciğer hacmi 918.265 (580-1230) cc idi. Ameliyat öncesi tahmini greft ağırlığı ve gerçek greft ağırlığı ortalama ağırlıkları sırasıyla 818.119 (550-1171) gr, 790.359 (505-1150) gr ölçüldü. Gerçek greft ağırlığı ile preoperatif tahmini greft volümü arasında istatistiksel bir ilişki yoktu. Ancak gerçek greft ağırlığı ile preoperatif tahmini greft ağırlığı arasında güçlü bir istatistiksel ilişki tespit edildi. Pearson korelasyon analizi sonuçları güçlü bir korelasyon gösterdi (r = 0.98, p <0.001) ve regresyon modelinin sonucu bu bulguyu destekledi (p <0.0001). Sonuç: Sonuç olarak canlıdan karaciğer naklinde greftin değerlendirilmesinde bilgisayarlı tomografi ile ölçülen volümün gerçek ağırlıktan farklı olduğu, Lemke ve ark.’nın geliştirdiği formülün aktüel ağırlığı tahminde yeterli ve etkili olduğu tespit edildi.

Anahtar Kelimeler:

Karaciğer nakli, bilgisayarlı tomografi, organ boyutu

Role of computed tomography in estimating graft weight measured intraoperatively before living donor liver transplantation

Background and Aims: The aim of our study was to evaluate the graft in an alive donor liver for transplantation using computerized tomography (CT) estimated graft volume, which is calculated by comparing the estimated graft weight with the actual graft weight through a correction factor and its efficacy. Materials and Methods: The dynamic contrast-enhanced hepatic computerized tomography scans of 42 alive liver donors (20 females, 22 males; mean [standard deviation, range] age, 42.23 [17.25, 18–52] years), consecutively registered from January 2009 to July 2015 were retrospectively analyzed in this study. The donors were healthy adults who had undergone resection of the right liver lobe for liver transplantation. The calculated estimated graft volume was compared with the actual intraoperative graft weight of the harvested right hepatic lobe. Results: The mean preoperative liver volume was found to be 918.265 (580–1230) cc. The mean (range) calculated preoperative estimated graft weight and the actual graft weight were 818.119 (550–1171) g and 790.357 (505–1150) g, respectively. No significant association was found between the actual graft weight and the preoperative estimated graft volume. However, there was a strong statistical association between the actual graft weight and preoperative estimated graft weight. The Pearson’s correlation analysis revealed a strong correlation (r = 0.98, p < 0.001), and the result of the regression model supported the finding (P < 0.0001). Conclusions: We found that the computerized tomography-estimated graft volume is different from the preoperative actual weight, and the current formula used worldwide is adequate and efficient for predicting the actual weight for evaluating the graft in a living donor liver for transplantation.

Keywords:

Liver transplantation, tomography, organ size,

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