Comparison of Two Methods of Future Liver Remnant Volume Measurement

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dc.contributor.author Shin Chun, Yun
dc.contributor.author Ribero, Dario
dc.contributor.author Abdalla, Eddie
dc.contributor.author Madoff, David
dc.contributor.author Mortenson, Melinda
dc.contributor.author Wei, Steven
dc.contributor.author Vauthey, Nicolas
dc.date.accessioned 2015-11-17T07:09:05Z
dc.date.available 2015-11-17T07:09:05Z
dc.date.copyright 2007
dc.date.issued 2015-11-17
dc.identifier.issn 1091-255X en_US
dc.identifier.uri http://hdl.handle.net/10725/2587
dc.description.abstract Background In liver transplantation, a minimum graft to patient body weight (BW) ratio is required for graft survival; in liver resection, total liver volume (TLV) calculated from body surface area (BSA) is used to determine the future liver remnant (FLR) volume needed for safe hepatic resection. These two methods of estimating liver volume have not previously been compared. The purpose of this study was to compare FLR volumes standardized to BW versus BSA and to assess their utility in predicting postoperative hepatic dysfunction after hepatic resection. Methods Records were reviewed of 68 consecutive noncirrhotic patients who underwent major hepatectomy after portal vein embolization between 1998 and 2006. FLR (cubic centimeter) was measured preoperatively with three-dimensional helical computed tomography; TLV (cubic centimeter) was calculated from the patients’ BSA. The relationship between FLR/TLV and FLR/BW (cubic centimeter per kilogram) was examined using linear regression analysis. Receiver operating characteristic (ROC) curve analysis was used to determine FLR/TLV and FLR/BW cutoff values for predicting postoperative hepatic dysfunction (defined as peak bilirubin level > 3 mg/dl or prothrombin time > 18 s). Results Regression analysis revealed that the FLR/TLV and FLR/BW ratios were highly correlated (Pearson correlation coefficient, 0.98). The area under the ROC curve was 0.85 for FLR/TLV and 0.84 for FLR/BW (95% confidence interval, 0.71–0.97). Sixteen of the 68 patients developed postoperative hepatic dysfunction. The ROC curve analysis yielded a cutoff FLR/BW value of ≤0.4, which had a positive predictive value (PPV) of 78% and a negative predictive value (NPV) of 85%. The corresponding FLR/TLV cutoff value of ≤20% had a PPV of 80% and a NPV of 86%. Conclusions Based on the strong correlation between the FLR measurements standardized to BW and BSA and their similar ability to predict postoperative hepatic dysfunction, both methods are appropriate for assessing liver volume. In noncirrhotic patients, a FLR/BW ratio of ≤0.4 and FLR/TLV of ≤20% provide equivalent thresholds for performing safe hepatic resection. en_US
dc.language.iso en en_US
dc.title Comparison of Two Methods of Future Liver Remnant Volume Measurement en_US
dc.type Article en_US
dc.description.version Published en_US
dc.author.school SOM en_US
dc.author.idnumber 201100945 en_US
dc.author.woa N/A en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Journal of Gastrointestinal Surgery en_US
dc.journal.volume 12 en_US
dc.journal.issue 1 en_US
dc.article.pages 123-128 en_US
dc.keywords Future liver remnant en_US
dc.keywords Total liver volume en_US
dc.keywords Hepatic insufficiency en_US
dc.identifier.doi http://dx.doi.org/10.1007/s11605-007-0323-8 en_US
dc.identifier.ctation Chun, Y. S., Ribero, D., Abdalla, E. K., Madoff, D. C., Mortenson, M. M., Wei, S. H., & Vauthey, J. N. (2008). Comparison of two methods of future liver remnant volume measurement. Journal of Gastrointestinal Surgery, 12(1), 123-128. en_US
dc.author.email eddie.abdalla@lau.edu.lb
dc.identifier.url http://link.springer.com/article/10.1007/s11605-007-0323-8

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