Peri-Operative Liver Regeneration of the Remnant Liver Volume after Right Hepatectomy for Living Donation: A Multiple Regression Analysis

Early liver regeneration was studied in a series of 70 patients who underwent right hepatectomy for living donation from November 2004 to January 2010. Liver regeneration was evaluated by multidetector computed tomography at a mean time of 61.07 days after surgery. Pre-surgical variables such as age, weight, height, body mass index, liver function tests, creatinine, platelet count, international normalized ratio, glucose, and variables detected with preoperative multidetector computed tomography imaging, including diameter of main portal vein, steatosis, original liver volume and spleen volume, were investigated as potential predictors of liver regeneration. Future remnant liver volume was preoperatively calculated by a virtual surgical cut. Liver function tests and creatinine were recorded on the 30(th) postoperative day. In addition, the onset of postoperative complications occurring within 90 days of surgery and codified within the five tiers of the Clavien-Dindo classification was analyzed. Hepatic regeneration of 100% or more at two months occurred in 26 of the 70 patients (37.14%). There was no association between the clinical outcome and the liver regeneration rate. Stepwise multiple regression analysis showed that higher body mass index: (0.035; p<0.0001), preoperative parameters such as smaller future remnant liver volume (0.002; P<0.0001), and greater spleen volume/future remnant liver volume ratio (1.196; P<0.0001) were predictors of greater liver regeneration. © 2012 American Association for the Study of Liver Diseases.