Right hepatectomy for living donation: Role of remnant liver volume in predicting hepatic dysfunction and complications

Autores
Facciuto, Marcelo; Contreras Saldivar, Alan; Singh, Manoj K.; Rocca, Juan Pablo; Taouli, Bachir; Oyfe, Irina; LaPointe Rudow, Dianne; Gondolesi, Gabriel Eduardo; Schiano, Thomas; Kim Schluger, Leona; Schwartz, Myron E.; Miller, Charles M.; Florman, Sander
Año de publicación
2013
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
BACKGROUND: Extensive attention has been placed on remnant liver volume (RLV) above other factors to ensure donor safety. METHODS: We performed a retrospective review of 137 right hepatectomies in live donors between June 1999 and November 2010. RESULTS: Median right lobe volume was 1,029 cm(3), which correlated with its actual weight (r = 0.63, P < .01); median RLV was 548 cm(3). Of the donors, 32 (24%) developed postoperative hepatic dysfunction (bilirubin >3 mg/dL or prothrombin time >18 s on postoperative day 4). RLV did not predict postoperative hepatic dysfunction (P = .9), but it was associated with peak international normalized ratio (INR) (P = .04). Donor age and male gender were predictors of increased bilirubin at postoperative day 4 (age, P = .03; gender, P = .02). Of the donors, 45 (33%) experienced complications, and 24 donors had RLVs <30%; 42% experienced complications compared to 31% of donors whose RLVs were greater than 30% (P = .3). Cell-saver utilization and aspartate-aminotransferase (AST) levels (OR = 3) were associated with complications. Volumetric assessment can predict RLV accurately. CONCLUSION: Although no demonstrable association between RLV <30% and complications was found, an RLV of 30% should remain the threshold for donor safety. Age and gender should be balanced in donors with a near threshold RLV of 30%. Surgical complexity, suggested by the need for intraoperative autoinfusion of blood and postoperative levels of AST, remained the independent predictor of complications.
Fil: Facciuto, Marcelo. Mount Sinai Medical Center; Estados Unidos
Fil: Contreras Saldivar, Alan. Mount Sinai Medical Center; Estados Unidos
Fil: Singh, Manoj K.. Mount Sinai Medical Center; Estados Unidos
Fil: Rocca, Juan Pablo. Mount Sinai Medical Center; Estados Unidos
Fil: Taouli, Bachir. Mount Sinai Medical Center; Estados Unidos
Fil: Oyfe, Irina. Columbia University; Estados Unidos
Fil: LaPointe Rudow, Dianne. Mount Sinai Medical Center; Estados Unidos
Fil: Gondolesi, Gabriel Eduardo. Fundación Favaloro; Argentina. Universidad Favaloro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Schiano, Thomas. Mount Sinai Medical Center; Estados Unidos
Fil: Kim Schluger, Leona. Mount Sinai Medical Center; Estados Unidos
Fil: Schwartz, Myron E.. Mount Sinai Medical Center; Estados Unidos
Fil: Miller, Charles M.. Cleveland Clinic. Digestive Disease Institute. Department of Hepato-Pancreato-Biliary and Transplant Surgery ; Estados Unidos
Fil: Florman, Sander. Mount Sinai Medical Center; Estados Unidos
Materia
Liver Trnasplant
Right Love
Living Donor
Volume
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/22893
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/22893
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Right hepatectomy for living donation: Role of remnant liver volume in predicting hepatic dysfunction and complicationsFacciuto, MarceloContreras Saldivar, AlanSingh, Manoj K.Rocca, Juan PabloTaouli, BachirOyfe, IrinaLaPointe Rudow, DianneGondolesi, Gabriel EduardoSchiano, ThomasKim Schluger, LeonaSchwartz, Myron E.Miller, Charles M.Florman, SanderLiver TrnasplantRight LoveLiving DonorVolumehttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3BACKGROUND: Extensive attention has been placed on remnant liver volume (RLV) above other factors to ensure donor safety. METHODS: We performed a retrospective review of 137 right hepatectomies in live donors between June 1999 and November 2010. RESULTS: Median right lobe volume was 1,029 cm(3), which correlated with its actual weight (r = 0.63, P < .01); median RLV was 548 cm(3). Of the donors, 32 (24%) developed postoperative hepatic dysfunction (bilirubin >3 mg/dL or prothrombin time >18 s on postoperative day 4). RLV did not predict postoperative hepatic dysfunction (P = .9), but it was associated with peak international normalized ratio (INR) (P = .04). Donor age and male gender were predictors of increased bilirubin at postoperative day 4 (age, P = .03; gender, P = .02). Of the donors, 45 (33%) experienced complications, and 24 donors had RLVs <30%; 42% experienced complications compared to 31% of donors whose RLVs were greater than 30% (P = .3). Cell-saver utilization and aspartate-aminotransferase (AST) levels (OR = 3) were associated with complications. Volumetric assessment can predict RLV accurately. CONCLUSION: Although no demonstrable association between RLV <30% and complications was found, an RLV of 30% should remain the threshold for donor safety. Age and gender should be balanced in donors with a near threshold RLV of 30%. Surgical complexity, suggested by the need for intraoperative autoinfusion of blood and postoperative levels of AST, remained the independent predictor of complications.Fil: Facciuto, Marcelo. Mount Sinai Medical Center; Estados UnidosFil: Contreras Saldivar, Alan. Mount Sinai Medical Center; Estados UnidosFil: Singh, Manoj K.. Mount Sinai Medical Center; Estados UnidosFil: Rocca, Juan Pablo. Mount Sinai Medical Center; Estados UnidosFil: Taouli, Bachir. Mount Sinai Medical Center; Estados UnidosFil: Oyfe, Irina. Columbia University; Estados UnidosFil: LaPointe Rudow, Dianne. Mount Sinai Medical Center; Estados UnidosFil: Gondolesi, Gabriel Eduardo. Fundación Favaloro; Argentina. Universidad Favaloro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Schiano, Thomas. Mount Sinai Medical Center; Estados UnidosFil: Kim Schluger, Leona. Mount Sinai Medical Center; Estados UnidosFil: Schwartz, Myron E.. Mount Sinai Medical Center; Estados UnidosFil: Miller, Charles M.. Cleveland Clinic. Digestive Disease Institute. Department of Hepato-Pancreato-Biliary and Transplant Surgery ; Estados UnidosFil: Florman, Sander. Mount Sinai Medical Center; Estados UnidosElsevier2013-02info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/22893Facciuto, Marcelo; Contreras Saldivar, Alan; Singh, Manoj K.; Rocca, Juan Pablo; Taouli, Bachir; et al.; Right hepatectomy for living donation: Role of remnant liver volume in predicting hepatic dysfunction and complications; Elsevier; Surgery; 153; 5; 2-2013; 619-6260039-6060CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/http://www.sciencedirect.com/science/article/pii/S0039606012007337info:eu-repo/semantics/altIdentifier/doi/10.1016/j.surg.2012.11.020info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-03T10:09:02Zoai:ri.conicet.gov.ar:11336/22893instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-03 10:09:02.256CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Right hepatectomy for living donation: Role of remnant liver volume in predicting hepatic dysfunction and complications
title Right hepatectomy for living donation: Role of remnant liver volume in predicting hepatic dysfunction and complications
spellingShingle Right hepatectomy for living donation: Role of remnant liver volume in predicting hepatic dysfunction and complications
Facciuto, Marcelo
Liver Trnasplant
Right Love
Living Donor
Volume
title_short Right hepatectomy for living donation: Role of remnant liver volume in predicting hepatic dysfunction and complications
title_full Right hepatectomy for living donation: Role of remnant liver volume in predicting hepatic dysfunction and complications
title_fullStr Right hepatectomy for living donation: Role of remnant liver volume in predicting hepatic dysfunction and complications
title_full_unstemmed Right hepatectomy for living donation: Role of remnant liver volume in predicting hepatic dysfunction and complications
title_sort Right hepatectomy for living donation: Role of remnant liver volume in predicting hepatic dysfunction and complications
dc.creator.none.fl_str_mv Facciuto, Marcelo
Contreras Saldivar, Alan
Singh, Manoj K.
Rocca, Juan Pablo
Taouli, Bachir
Oyfe, Irina
LaPointe Rudow, Dianne
Gondolesi, Gabriel Eduardo
Schiano, Thomas
Kim Schluger, Leona
Schwartz, Myron E.
Miller, Charles M.
Florman, Sander
author Facciuto, Marcelo
author_facet Facciuto, Marcelo
Contreras Saldivar, Alan
Singh, Manoj K.
Rocca, Juan Pablo
Taouli, Bachir
Oyfe, Irina
LaPointe Rudow, Dianne
Gondolesi, Gabriel Eduardo
Schiano, Thomas
Kim Schluger, Leona
Schwartz, Myron E.
Miller, Charles M.
Florman, Sander
author_role author
author2 Contreras Saldivar, Alan
Singh, Manoj K.
Rocca, Juan Pablo
Taouli, Bachir
Oyfe, Irina
LaPointe Rudow, Dianne
Gondolesi, Gabriel Eduardo
Schiano, Thomas
Kim Schluger, Leona
Schwartz, Myron E.
Miller, Charles M.
Florman, Sander
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Liver Trnasplant
Right Love
Living Donor
Volume
topic Liver Trnasplant
Right Love
Living Donor
Volume
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv BACKGROUND: Extensive attention has been placed on remnant liver volume (RLV) above other factors to ensure donor safety. METHODS: We performed a retrospective review of 137 right hepatectomies in live donors between June 1999 and November 2010. RESULTS: Median right lobe volume was 1,029 cm(3), which correlated with its actual weight (r = 0.63, P < .01); median RLV was 548 cm(3). Of the donors, 32 (24%) developed postoperative hepatic dysfunction (bilirubin >3 mg/dL or prothrombin time >18 s on postoperative day 4). RLV did not predict postoperative hepatic dysfunction (P = .9), but it was associated with peak international normalized ratio (INR) (P = .04). Donor age and male gender were predictors of increased bilirubin at postoperative day 4 (age, P = .03; gender, P = .02). Of the donors, 45 (33%) experienced complications, and 24 donors had RLVs <30%; 42% experienced complications compared to 31% of donors whose RLVs were greater than 30% (P = .3). Cell-saver utilization and aspartate-aminotransferase (AST) levels (OR = 3) were associated with complications. Volumetric assessment can predict RLV accurately. CONCLUSION: Although no demonstrable association between RLV <30% and complications was found, an RLV of 30% should remain the threshold for donor safety. Age and gender should be balanced in donors with a near threshold RLV of 30%. Surgical complexity, suggested by the need for intraoperative autoinfusion of blood and postoperative levels of AST, remained the independent predictor of complications.
Fil: Facciuto, Marcelo. Mount Sinai Medical Center; Estados Unidos
Fil: Contreras Saldivar, Alan. Mount Sinai Medical Center; Estados Unidos
Fil: Singh, Manoj K.. Mount Sinai Medical Center; Estados Unidos
Fil: Rocca, Juan Pablo. Mount Sinai Medical Center; Estados Unidos
Fil: Taouli, Bachir. Mount Sinai Medical Center; Estados Unidos
Fil: Oyfe, Irina. Columbia University; Estados Unidos
Fil: LaPointe Rudow, Dianne. Mount Sinai Medical Center; Estados Unidos
Fil: Gondolesi, Gabriel Eduardo. Fundación Favaloro; Argentina. Universidad Favaloro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Schiano, Thomas. Mount Sinai Medical Center; Estados Unidos
Fil: Kim Schluger, Leona. Mount Sinai Medical Center; Estados Unidos
Fil: Schwartz, Myron E.. Mount Sinai Medical Center; Estados Unidos
Fil: Miller, Charles M.. Cleveland Clinic. Digestive Disease Institute. Department of Hepato-Pancreato-Biliary and Transplant Surgery ; Estados Unidos
Fil: Florman, Sander. Mount Sinai Medical Center; Estados Unidos
description BACKGROUND: Extensive attention has been placed on remnant liver volume (RLV) above other factors to ensure donor safety. METHODS: We performed a retrospective review of 137 right hepatectomies in live donors between June 1999 and November 2010. RESULTS: Median right lobe volume was 1,029 cm(3), which correlated with its actual weight (r = 0.63, P < .01); median RLV was 548 cm(3). Of the donors, 32 (24%) developed postoperative hepatic dysfunction (bilirubin >3 mg/dL or prothrombin time >18 s on postoperative day 4). RLV did not predict postoperative hepatic dysfunction (P = .9), but it was associated with peak international normalized ratio (INR) (P = .04). Donor age and male gender were predictors of increased bilirubin at postoperative day 4 (age, P = .03; gender, P = .02). Of the donors, 45 (33%) experienced complications, and 24 donors had RLVs <30%; 42% experienced complications compared to 31% of donors whose RLVs were greater than 30% (P = .3). Cell-saver utilization and aspartate-aminotransferase (AST) levels (OR = 3) were associated with complications. Volumetric assessment can predict RLV accurately. CONCLUSION: Although no demonstrable association between RLV <30% and complications was found, an RLV of 30% should remain the threshold for donor safety. Age and gender should be balanced in donors with a near threshold RLV of 30%. Surgical complexity, suggested by the need for intraoperative autoinfusion of blood and postoperative levels of AST, remained the independent predictor of complications.
publishDate 2013
dc.date.none.fl_str_mv 2013-02
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/22893
Facciuto, Marcelo; Contreras Saldivar, Alan; Singh, Manoj K.; Rocca, Juan Pablo; Taouli, Bachir; et al.; Right hepatectomy for living donation: Role of remnant liver volume in predicting hepatic dysfunction and complications; Elsevier; Surgery; 153; 5; 2-2013; 619-626
0039-6060
CONICET Digital
CONICET
url http://hdl.handle.net/11336/22893
identifier_str_mv Facciuto, Marcelo; Contreras Saldivar, Alan; Singh, Manoj K.; Rocca, Juan Pablo; Taouli, Bachir; et al.; Right hepatectomy for living donation: Role of remnant liver volume in predicting hepatic dysfunction and complications; Elsevier; Surgery; 153; 5; 2-2013; 619-626
0039-6060
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/http://www.sciencedirect.com/science/article/pii/S0039606012007337
info:eu-repo/semantics/altIdentifier/doi/10.1016/j.surg.2012.11.020
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
_version_ 1842270066434899968
score 13.13397

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