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Assessment of liver graft function and regeneration by galactosyl‐human serum albumin ( 99m Tc‐GSA) liver scintigraphy in adult living‐donor liver transplantation
Author(s) -
Iida Taku,
Isaji Shuji,
Yagi Shintaro,
Hori Tomohide,
Taniguchi Kentaro,
Ohsawa Ichiro,
Mizuno Shugo,
Usui Masanobu,
Sakurai Hiroyuki,
Yamagiwa Kentaro,
Yamakado Kouichiro,
Uemoto Shinji
Publication year - 2009
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2008.00933.x
Subject(s) - medicine , scintigraphy , liver transplantation , gastroenterology , living donor liver transplantation , liver function , liver disease , albumin , liver regeneration , urology , surgery , liver function tests , serum albumin , transplantation , regeneration (biology) , biology , microbiology and biotechnology
Background: In adult living‐donor liver transplantation (LDLT), the assessment of the graft functional reserve is very important. We evaluated the graft functional reserve by technetium‐99m‐diethylenetriaminepenta‐acetic acid‐galactosyl‐human serum albumin ( 99m Tc‐GSA) liver scintigraphy. Patients and method: From May 2003 to September 2006, 99m Tc‐GSA studies were performed in 27 adult recipients on two, four wk after LDLT, the receptor index [ratio of liver to heart‐plus‐liver radioactivity at 15 minutes (LHL15)] (LHL15) was calculated. Recipients were divided into two groups according to LHL15 on two wk after LDLT (group H; >0.935, group L; <0.935). Liver functional tests and recipients’ background parameters were evaluated between the two groups. Result: Group L accompanied higher preoperative model for end‐stage liver disease (MELD) score (p = 0.038), lower graft‐recipient weight ratio (GRWR) (p = 0.032) and older donor age (p = 0.003) compared with group H. There was no significant difference in the graft regeneration rate between two groups. The three‐yr cumulative survival rate was 76.1% in group L and 88.9% in group H. Conclusion: In LDLT, LHL15 has the potential to assess the graft function and predict the recipients’ outcome. Graft function after LDLT may be related closely to the pretransplant MELD score, GRWR, and donor age.