GRAFT SIZE ASSESSMENT BY PREOPERATIVE COMPUTED-TOMOGRAPHY IN LIVING RELATED PARTIAL LIVER-TRANSPLANTATION

The size of segmental liver grafts assessed by preoperative computed t omography (CT) volumetry was evaluated in relation to surgical outcome in 14 living related partial liver transplantations (LRLTs). The aim was to show that graft size can be accurately assessed before operatio n and to estimate the lower safety limit of graft size in assessing su bsequent graft function and survival. The relationship between calcula ted CT volume and weight of the liver was linear in the recipient (r = 0.97) and donor (r = 0.98). The mean(s.e.m.) modified liver weight ra tio (MLWR; ratio of graft weight to recipient's expected liver weight based on body-weight) was 0.59(0.07) (range 0.27-1.09). Surgical compl ications related to an oversized graft and primary graft failure cause d by a small-for-size graft were not observed. The lowest MLWR of any survivor was 0.27. These results suggest that a partial liver graft re duced to about 30 per cent of the recipient's expected liver weight ca n tolerate LRLT well.