活体肝移植中肝体积估算方法的评价：CT体积法与MeVis，并比较开放和腹腔镜手术。

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-01-20 DOI:10.1016/j.transproceed.2024.12.017

Ek Khoon Tan , Victoria Zheng , Seok Yin Tuieng , Albert Su Chong Low , Steve Tian Sung Chai , Yi Xuan Phang , Ye Xin Koh , Alexander Yaw Fui Chung , Peng Chung Cheow , Prema Raj Jeyaraj , Brian Kim Poh Goh

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引用次数: 0

摘要

背景：在活体肝移植中，准确评估移植物体积对供体和受体的安全至关重要。这可以使用手动计算机断层扫描容积法（CTvol）或半自动方法（MeVis）进行。我们的目的是比较CTvol和MeVis在估计LDLT期间实际移植物重量方面的差异，并分析腹腔镜和开放式供肝切除术之间的重量差异。方法：对2015 - 2022年影像资料完整的活体供体进行回顾性研究。使用(1)CT体积法和(2)半自动MeVis软件估计移植物重量。主要转归为移植物体重方差（[预测体重-实际体重]/预测体重）× 100。次要结局是开放或腹腔镜手术是否影响移植物重量方差。结果：33例供体中，52.6%为右肝，未移植肝中静脉。19例（57.6%）供者行开放性肝切除术。CTvol (r = 0.70；P < 0.001)和MeVis (r = 0.85；P < 0.001)与实际移植重量密切相关。开放式和腹腔镜下CTvol的体重方差分别为-2.9%和-15.3% (P = 0.04)， MeVis的体重方差分别为-0.9%和-8.5% （P = 0.11）。MeVis预测的实际移植物与受体重量比在开放和腹腔镜入路之间相似(-0.01 vs 0.07；P = .12)。结论：CT体积测量和MeVis显示预测和实际移植重量有很强的相关性。腹腔镜肝切除术显示用CT容积法估计移植物重量的变异性更大，但MeVis在开放和腹腔镜手术中相似。

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Evaluation of Liver Volume Estimation Methods in Living Donor Liver Transplant: CT Volumetry vs MeVis, With Comparison of Open and Laparoscopic Surgery

Background

Accurately assessing graft volume is crucial for donor and recipient safety in living donor liver transplantation. This can be performed using manual computed tomography volumetry (CTvol) or semiautomated methods (MeVis). We aimed to compare CTvol and MeVis in estimating the actual graft weight during LDLT, and analyse any differences in weight between laparoscopic and open donor hepatectomy.

Methods

A retrospective study of living donors between 2015 and 2022 with complete imaging data was performed. Graft weights were estimated using (1) CT volumetry and (2) semiautomated MeVis software. The primary outcome was graft weight variance ([Predicted weight–Actual weight]/Predicted weight) × 100. The secondary outcome of interest was whether open or laparoscopic surgery affected graft weight variance.

Results

Of the 33 donors, 52.6% were right liver without middle hepatic vein grafts. Nineteen donors (57.6%) underwent open hepatectomy. Both CTvol (r = 0.70; P < .001) and MeVis (r = 0.85; P < .001) showed strong correlation with actual graft weight. Weight variance using CTvol was −2.9% vs −15.3% (P = .04) for open vs laparoscopic, while the corresponding using MeVis was −0.9% vs −8.5% (P = .11). Actual graft-to-recipient weight ratio predicted by MeVis was similar between open and laparoscopic approaches (−0.01 vs 0.07; P = .12).

Conclusions

Both CT volumetry and MeVis showed strong correlation between predicted and actual graft weights. Laparoscopic hepatectomy showed greater variability in graft weight estimation using CT volumetry, but MeVis was similar across both open and laparoscopic surgery.

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.