Residual Liver Volume as a Predictive Value for Donor Outcome in Adult Right Lobe Living Donor Liver Transplant

Abstract

SUMMARY ight lobe liver donation is a widely accepted procedure that results in the expansion of the indication for LDLT to adults and elder children. However, remnant liver size and anatomical variations in the biliary tree represent important risk factors for postoperative complications. The incidence of severe hepatic dysfunction and infection following liver resection increased significantly with smaller RLV. There are several factors affecting donors complication rate in donors such as demographic data, volumetric data, operative techniques and postoperative care and follow up. Although that small Functioning Residual Liver Volume (FRLV) tends to regenerate more and faster, confirming that a larger resections may lead to a greater promotion of liver regeneration in patients with optimal conditions in terms of body habitus, preoperative liver function tests, and glucose level Regeneration of liver occurs in 3 phases: early phase of rapid regeneration occurring in the first 2 weeks postoperatively which is associated with vascular engorgement. The second phase takes place 1±2 months postoperatively, and is characterized by a decrease in liver volume that is thought to be associated with the normalization of the vascular engorgement and resolution of R Summary 90 tissue edema. In the final phase, there is a slow increase in liver volume. Mechanisms of liver regeneration are highly complicated dependent on molecular pathway with specific stop signal. In the past, several surgeons documented the accepted lower safety margin of donor remnant liver volume might be 30% of the total liver volume in LDLT, Otherwise, a tragedy caused by an extremely small remnant liver would occur Even though the settled limit of remnant liver volume was at 35%. There have been devastating consequences after living liver donation around the world, most of which occurred after right hepatic donation. So for issue of donor safety we studied the RLV with higher percentages to emphasize in effect of RLV on donor liver function postoperatively, donor complication and donor welfare. The issue of donor is mainly not morbidity, the world is now to donor welfare so in order to minimize complications as possible, so we studied donors with larger RLV.