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Volumetric and functional recovery of the liver after right hepatectomy for living donation
Author(s) -
Nadalin Silvio,
Testa Giuliano,
Malagó Massimo,
Beste Mechtild,
Frilling Andrea,
Schroeder Thobias,
Jochum Christoph,
Gerken Guido,
Broelsch Christoph E.
Publication year - 2004
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.20182
Subject(s) - hepatectomy , medicine , liver function , urology , cholinesterase , liver transplantation , albumin , bilirubin , volume (thermodynamics) , liver function tests , liver regeneration , surgery , nuclear medicine , resection , transplantation , biology , physics , quantum mechanics , regeneration (biology) , microbiology and biotechnology
Our objective was to study the kinetics of recovery of the liver volume and liver function after right hepatectomy (RH) for living donation, comparing conventional and quantitative liver function tests, i.e., galactose elimination capacity (GEC). A total of 27 donors underwent RH averaging 61% of the whole liver volume. The conventional and quantitative liver function tests, as well as magnetic resonance imaging volumetric studies, were performed preoperatively at postoperative day (POD) 10, 90, 180, and 360. Mean residual volume increased by 88% within 10 days from RH and thereafter did not show any significant variation. After 1 year, only 83% of the original volume was reached. GEC per milliliter of liver volume expressed in percent of initial value (GEC/mL) showed a decrease of 25% at POD10, an increase up to 125% at POD 180, and returned to normal values at POD 360. Liver biochemistries, International Normalized Ratio (INR), and bilirubin returned to normal in 10 days. Cholinesterase showed a similar course like GEC. In conclusion, within 10 days of 61% loss of its initial volume, the liver is capable of regenerating a volume necessary to its function, although it corresponds to only 74% of the initial one. It takes only 10 days to normalize liver biochemistries, while cholinesterase and albumin recover over 90 days. However, a direct measure of the cytosolic liver function obtained by GEC shows that functional recovery occurs much more gradually than the recovery of volume and liver biochemistries. (Liver Transpl 2004;10:1024–1029.)