Study of Dynamic Changes of Postoperative Liver Reserve Function and Liver Volume Regeneration for Recipients Underwent Living Donor Liver Transplantation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YIN Jie , LI Bo , DU Zhenggui , FENG Xi , WEI Yonggang , LI Fuqiang , YAN Lnan , WEN Tianfu , TANG Li.

Department of Hepatic and Peripheral Vascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

Keywords：

Hepatic reserve function; Indocyanine green excretive test; Volume regeneration; Living donor liver transplantation

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the dynamic changes of postoperative liver reserve function and laboratory liver function as well as liver volume regeneration, and their potential relationship with short-term clinical outcomes after adult-to-adult living donor liver transplantation (LDLT).
Methods The data of 30 recipients underwent LDLT were prospectively collected. The plasma clearance (K) by indocyanine green (ICG) excretive test, liver function test by laboratory methods, liver volume by CT and shortterm ( lt;3 months) complications were analyzed.
Results The graft recipient body weight ratio (GRBW) was 0.63%-1.43%. The hepatic volume of the recipients in the operation was (638±103) ml, which was smaller than that day 7, 30, and 90 after operation (P lt;0.001), but the hepatic volume at subsequent time point was not different from that at the former time point (P gt;0.05). The KICG values of recipients among the day 3 〔(0.177±0.056)/min〕, 7 〔(0.183±0.061)/min〕, 30 〔(0.200±0.049)/min〕, and 90 〔(0.209±0.050)/min〕 after operation gradually increased, which was respectively higher than that of recipients before operation (P=0.006, P=0.002, P lt;0.001, and P lt;0.001). Compared with the baseline KICG 〔(0.228±0.036)/min〕 of the donors, the KICG of recipients showed significant variation on day 3 and 7 after operation (P=0.004 and P=0.015), and the KICG of recipients on day 30 and 90 after operation approached the baseline KICG (P=0.355 and P=0.915). The recipients were divided into good liver function group (n=23) and poor liver function group (n=7) according to total serum bilirubin on day 14 after operation. The KICG significantly dropped compared with the recipients of good liver function group on day 3 after operation (P=0.001). Conclusions The liver volume regenerates dramatically on day 7 after operation for the recipients. The ICG excretivetest shows that volume recovery occurs much more gradually than the recovery of function in the recipients. The ICG excretive test is a more reliable indicator of graft function and subsequent graft outcome early after LDLT.

Citation： YIN Jie,LI Bo,DU Zhenggui,FENG Xi,WEI Yonggang,LI Fuqiang,YAN Lnan,WEN Tianfu,TANG Li.. Study of Dynamic Changes of Postoperative Liver Reserve Function and Liver Volume Regeneration for Recipients Underwent Living Donor Liver Transplantation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(8): 789-794. doi: Copy

1.	Marcos A, Fisher RA, Ham JM, et al. Liver regeneration and function in donor and recipient after right lobe adult to adult living donor liver transplantation [J]. Transplantation, 2000; 69(3): 13751379.
2.	Pomfret EA, Pomposelli JJ, Lewis WD, et al. Live donor adult liver transplantation using right lobe grafts: donor evaluation and surgical outcome [J]. Arch Surg, 2001; 136(4): 425433.
3.	Pomfret EA, Pomposelli JJ, Gordon FD, et al. Liver regeneration and surgical outcome in donors of rightlobe liver grafts [J]. Transplantation, 2003; 76(1): 510.
4.	Humar A, Kosari K, Sielaff TD, et al. Liver regeneration after adult living donor and deceased donor splitliver transplants [J]. Liver Transpl, 2004; 10(3): 374378.
5.	Kawasaki S, Makuuchi M, Ishizone S, et al. Liver regeneration in recipients and donors after transplantation [J]. Lancet, 1992; 339(8793): 580581.
6.	Kawasaki S, Makuuchi M, Matsunami H, et al. Living related liver transplantation in adults [J]. Ann Surg, 1998； 227(2): 269274.
7.	Pascher A, Sauer IM, Walter M, et al. Donor evaluation, donor risks, donor outcome, and donor quality of life in adulttoadult living donor liver transplantation [J]. Liver Transpl, 2002; 8(9): 829837.
8.	Akamatsu N, Sugawara Y, Tamura S, et al. Regeneration and function of hemiliver graft: right versus left [J]. Surgery, 2006; 139(6): 765772.
9.	杜正贵, 李波, 冯曦, 等. 脉搏染料光密度法吲哚氰绿排泄试验对评价肝癌切除术后肝功能不全的价值 [J]. 中国普外基础与临床杂志, 2009; 16(2): 133136.
10.	Maetani Y, Itoh K, Egawa H, et al. Factors influencing liver regeneration following livingdonor liver transplantation of the right hepatic lobe [J]. Transplantation 2003; 75(1): 97102.
11.	Jochum C, Beste M, Penndorf V, et al. Quantitative liver function tests in donors and recipients of living donor liver transplantation [J]. Liver Transpl, 2006; 12(4): 544549.
12.	Faybik P, Hetz H. Plasma disappearance rate of indocyanine green in liver dysfunction [J]. Transplant Proc, 2006; 38(3): 801802.
13.	路涛, 周翔平, 陈心足, 等. 肝炎后肝硬变病肝储备功能与其体积变化研究 [J]. 中国普外基础与临床杂志, 2006; 13(6): 729732.
14.	Hori T, Iida T, Yagi S, et al. KICG value, a reliable realtime estimator of graft function, accurately predicts outcomes in adult livingdonor liver transplantation [J]. Liver Transpl, 2006; 12(4): 605613.
15.	Piscaglia F, Zironi G, Gaiani S, et al. Systemic and splanchnic hemodynamic changes after liver transplantation for cirrhosis: a longterm prospective study [J]. Hepatology, 1999; 30(1): 5864.
16.	Navasa M, Feu F, GarcíaPagán JC, et al. Hemodynamic and humoral changes after liver transplantation in patients with cirrhosis [J]. Hepatology, 1993; 17(3): 355360.
17.	Thevananther S, Sun H, Li D, et al. Extracellular ATP activates cjun Nterminal kinase signaling and cell cycle progression in hepatocytes [J]. Hepatology, 2004; 39(2): 393402.
18.	Eguchi S, Yanaga K, Sugiyama N, et al. Relationship between portal venous flow and liver regeneration in patients after living donor rightlobe liver transplantation [J]. Liver Transpl, 2003; 9(6): 547551.
19.	Niemann CU, Yost CS, Mandell S, et al. Evaluation of the splanchnic circulation with indocyanine green pharmacokinetics in liver transplant patients [J]. Liver Transpl, 2002; 8(5): 476481.
20.	Niiya T, Murakami M, Aoki T, et al. Immediate increase of portal pressure, reflecting sinusoidal shear stress, induced liver regeneration after partial hepatectomy [J]. J Hepatobiliary Pancreat Surg, 1999; 6(3): 275280.
21.	Kelly DM, Demetris AJ, Fung JJ, et al. Procine partial liver transplantation: a novel model of the “smallforsize” liver graft [J]. Liver Transpl, 2004; 10(2): 253263.

1. Marcos A, Fisher RA, Ham JM, et al. Liver regeneration and function in donor and recipient after right lobe adult to adult living donor liver transplantation [J]. Transplantation, 2000; 69(3): 13751379.
2. Pomfret EA, Pomposelli JJ, Lewis WD, et al. Live donor adult liver transplantation using right lobe grafts: donor evaluation and surgical outcome [J]. Arch Surg, 2001; 136(4): 425433.
3. Pomfret EA, Pomposelli JJ, Gordon FD, et al. Liver regeneration and surgical outcome in donors of rightlobe liver grafts [J]. Transplantation, 2003; 76(1): 510.
4. Humar A, Kosari K, Sielaff TD, et al. Liver regeneration after adult living donor and deceased donor splitliver transplants [J]. Liver Transpl, 2004; 10(3): 374378.
5. Kawasaki S, Makuuchi M, Ishizone S, et al. Liver regeneration in recipients and donors after transplantation [J]. Lancet, 1992; 339(8793): 580581.
6. Kawasaki S, Makuuchi M, Matsunami H, et al. Living related liver transplantation in adults [J]. Ann Surg, 1998； 227(2): 269274.
7. Pascher A, Sauer IM, Walter M, et al. Donor evaluation, donor risks, donor outcome, and donor quality of life in adulttoadult living donor liver transplantation [J]. Liver Transpl, 2002; 8(9): 829837.
8. Akamatsu N, Sugawara Y, Tamura S, et al. Regeneration and function of hemiliver graft: right versus left [J]. Surgery, 2006; 139(6): 765772.
9. 杜正贵, 李波, 冯曦, 等. 脉搏染料光密度法吲哚氰绿排泄试验对评价肝癌切除术后肝功能不全的价值 [J]. 中国普外基础与临床杂志, 2009; 16(2): 133136.
10. Maetani Y, Itoh K, Egawa H, et al. Factors influencing liver regeneration following livingdonor liver transplantation of the right hepatic lobe [J]. Transplantation 2003; 75(1): 97102.
11. Jochum C, Beste M, Penndorf V, et al. Quantitative liver function tests in donors and recipients of living donor liver transplantation [J]. Liver Transpl, 2006; 12(4): 544549.
12. Faybik P, Hetz H. Plasma disappearance rate of indocyanine green in liver dysfunction [J]. Transplant Proc, 2006; 38(3): 801802.
13. 路涛, 周翔平, 陈心足, 等. 肝炎后肝硬变病肝储备功能与其体积变化研究 [J]. 中国普外基础与临床杂志, 2006; 13(6): 729732.
14. Hori T, Iida T, Yagi S, et al. KICG value, a reliable realtime estimator of graft function, accurately predicts outcomes in adult livingdonor liver transplantation [J]. Liver Transpl, 2006; 12(4): 605613.
15. Piscaglia F, Zironi G, Gaiani S, et al. Systemic and splanchnic hemodynamic changes after liver transplantation for cirrhosis: a longterm prospective study [J]. Hepatology, 1999; 30(1): 5864.
16. Navasa M, Feu F, GarcíaPagán JC, et al. Hemodynamic and humoral changes after liver transplantation in patients with cirrhosis [J]. Hepatology, 1993; 17(3): 355360.
17. Thevananther S, Sun H, Li D, et al. Extracellular ATP activates cjun Nterminal kinase signaling and cell cycle progression in hepatocytes [J]. Hepatology, 2004; 39(2): 393402.
18. Eguchi S, Yanaga K, Sugiyama N, et al. Relationship between portal venous flow and liver regeneration in patients after living donor rightlobe liver transplantation [J]. Liver Transpl, 2003; 9(6): 547551.
19. Niemann CU, Yost CS, Mandell S, et al. Evaluation of the splanchnic circulation with indocyanine green pharmacokinetics in liver transplant patients [J]. Liver Transpl, 2002; 8(5): 476481.
20. Niiya T, Murakami M, Aoki T, et al. Immediate increase of portal pressure, reflecting sinusoidal shear stress, induced liver regeneration after partial hepatectomy [J]. J Hepatobiliary Pancreat Surg, 1999; 6(3): 275280.
21. Kelly DM, Demetris AJ, Fung JJ, et al. Procine partial liver transplantation: a novel model of the “smallforsize” liver graft [J]. Liver Transpl, 2004; 10(2): 253263.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Study of Dynamic Changes of Postoperative Liver Reserve Function and Liver Volume Regeneration for Recipients Underwent Living Donor Liver Transplantation

Abstract Full text Figures/Tables Video References Cited by

Format

Content