Abstract
P1049
Introduction: Anatomical volumes of donor liver on CT cannot assess functional capacity of future liver remnant (FLR) and future graft and are not in linear correlation to functional volumes. Hepatobiliary scintigraphy (HBS) can benefit in this regard by estimating functional volumes of liver and could be a surrogate marker of hepatocyte volume and function
Methods: Ongoing prospective study. On CT, FLR and future graft volumes of donor's liver were calculated. On HBS, functional volumes and functional capacity (Mebrofenin uptake rate-MUR) were estimated. Donors with FLR of more than 28% and Graft to recipient weight ratio (GRWR) of more than 0.65% based on CT volumetry were included. Future graft and FLR volumes on CT were compared to functional volumes on HBS. In initial fifty living donor liver transplants, donor HBS results were kept blind. Later, in donors with borderline FLR or GRWR values, HBS results were considered in decision-making while choosing graft size and selecting donor
Results: Right lobes (RL) had higher functional volumes on HBS compared to CT volumes, whereas left lobes (LL) and left lateral sectors (LLS) had lower functional volumes (Table,figure). In four donors, RL was chosen as graft in view of good functional capacity despite low GRWRs (0.54 to 0.74), one had early allograft dysfunction (EAD) and subsequently improved. In two donors, RL was chosen in view of good functional capacity though the FLR volumes were borderline (28% and 30.4%) on CT, but minimal variation on HBS (29% and 27.5%). No incidence of post-hepatectomy liver failure. In five donors, LL was chosen as graft in view of good functional capacity of liver on HBS despite low GRWRs, one had EAD and improved
Conclusions: Including functional volumes in decision-making improves donor safety, and recipient outcomes and increases the donor pool
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