Ümit ÖZÇELİK, Eryiğit EREN, Yıldıray TUTPINAR, Devrim URUT, Mehmet TOKAC, Ayhan DİNÇKAN

Canlı Karaciğer Vericilerinde Karaciğerin Bilgisayarlı Tomografi ile Anatomik ve Hacimsel Analizi için Kullanılan Yeni Bir Yazılım Programı ile Hesaplanan Tahmini Greft Hacmi ile Gerçek Greft Ağırlığının Karşılaştırılması

Amaç: Canlı vericili karaciğer naklinde, alıcıda greftin alıcı ağırlığı-na oranının (GRWR) ve vericide ameliyat sonrası kalacak karaciğer hacminin ameliyat öncesi hacimsel analizle doğru tahmin edilmesi çok önemlidir. Bu çalışma ile karaciğer vericilerinde karaciğerin anatomik ve hacimsel analizinin yapılması için kullandığımız LiverVision® programı ile hesaplanmış tahmini sağ lob greft hacimlerinin (EGV) ameliyat sırasında arka-masada (back-table) ölçülen gerçek greft ağırlığı (AGW) ile karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: Çalışmamızda 01.01.2018-30.05.2020 tarihleri arasında canlı vericiden sağ lob karaciğer nakli yapılmış olan hastalar ve vericileri retrospektif olarak incelenmiştir. Hastaların demog-rafik bulguları, vücut kitle indeksi, EGV, AGW ve GRWR kayıt altına alınmıştır. Sürekli değişkenler arasındaki ilişkiler, Pearson korelasyon katsayısı, doğrusal regresyon analizi ve Bland Altman grafikleri ile değerlendirilmiştir.Bulgular: Ortalama yaşı 32,6±8,8 yıl olan toplam 108 karaciğer vericisi çalışmaya dâhil edilmiştir. Ortalama EGV tüm vericiler için, 902,5±147,1 mL iken, ortalama AGW tüm vericiler için 890,6±145,9 g olarak hesaplanmıştır. Tüm vericiler için EGV ile AGW arasında anlamlı bir korelasyon olduğu saptanmıştır (r=0,856, p<0,001). Bland-Altman metoduna göre 108 ölçümün 105'inde (%97,2) EGV, AGW ile %95 güven aralığı içerisinde saptanmıştır. AGW’yi hesaplamak için oluşturulan regresyon modeline göre AGW (g)=0,85xEGV (mL)+124,5 formülü elde edilmiştir (r2=0,732, p<0,001).Sonuç: Yeni geliştirilmiş Türk yapımı yarı otomatik LiverVision® yazılımı ile bilgisayarlı tomografi (BT) ile vericilerin karaciğer hacimleri başarılı bir şekilde tahmin edilebilmektedir.

Anahtar Kelimeler:

Karaciğer nakli, canlı karaciğer vericisi, tahmini greft hacmi; gerçek greft ağırlığı, yazılım program

A Comparison of Actual Graft Weight and Estimated Graft Volume Calculated with New Software Used for Anatomical and Volumetric Analysis of the Liver with Computed Tomography in Living Liver Donors

Objective: In the living donor liver transplantation (LDLT) context, accurate estimation of the graft weight to recipient weight ratio (GRWR) and future donor liver remnant volume by pre-operative volumetric analysis is very important. We aimed to compare the estimated graft volume (EGV) calculated with the LiverVision® soft-ware with the actual graft weight (AGW) measured in the back-ta-ble in this study.Material and Method: Patients who underwent right lobe LDLT and liver donors between 01.01.2018-30.05.2020 were retrospec-tively evaluated. Demographic data, body mass index, EGV, AGW and GRWR were recorded. Linear regression analysis, Pearson cor-relation coefficient and Bland-Altman plots were utilized for evalu-ation of the relationships between continuous variables.Results: A total of 108 liver donors were included in the study. The mean age of the donors was 32.6±8.8 years and mean EGV was 902.5±147.1 mL for all donors. The mean AGW was 890.6±145.9 g for all donors. A significant correlation was found between EGV and AGW for all donors (r=0.856, p<0.001). The mean difference between EGV and AGW was 11.9±78.5 for all donors. 105 of the 108ith CT with the newly developed Turkish semi-automatic LiverVision® software. (97.2%) measurements were within the 95% ranges of agreement be-tween EGV and AGW according to the Bland-Altman plot. According to the regression model created to calculate the AGW, the formula AGW (g)=0.85xEGV (mL)+124.5 was obtained (r2=0.732, p<0.001).Conclusion: The liver volumes of the donors were successfully estimat-ed with computed tomography (CT) with the newly developed Turkish semi-automatic LiverVision® software.

Keywords:

Liver transplantation, living liver donor, estimated graft vol-ume; actual graft weight, software,

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