Risk of venous congestion in live donors of extended right liver graft

Table 1 Etiology of liver disease among right graft recipients (n = 71)

Parameter	Number
Total	71
Male	43
Female	28
Autoimmune hepatitis	5
Hepatitis B	4
Hepatitis B associated with hepatocellular carcinoma (HCC)	7
Hepatitis C	8
Hepatitis C associated with HCC	10
Alcoholic	7
Alcoholic + associated with HCC	6
Morbus Wilson	2
Primary biliary sclerosis (PBC)	2
Primary sclerosing cholangitis (PSC)	7
HCC	4
Cryptogenic	6
Others1	3

¹Neuroendocrine lever metastases (n = 2), liver metastases from insulinoma.

Table 2 Concordant vs non-concordant interrelation between remnant volume (donor) body weight ratio and remnant volume percentage of total liver volume in discriminating small-for-size from non-small-for-size remnants according to two different cut-off values

Remnant status defined by Rvbwr		Remnant status defined by Rv/tlv
SFS	Non SFS	SFS	Non SFS
RVBWR < 0.65	RVBWR ≥ 0.65	RV/TLV < 30%	RV/TLV ≥ 30%
n = 8	n = 63	n = 6	n = 65
RV/TLV < 30%	RV/TLV < 30%	RVBWR < 0.65	RVBWR < 0.65
Concordant	Non-concordant	Concordant	Non-concordant
2/8	4/63	2/61	5/652
25%	6%	33%	8%
RV/TLV ≥ 30%	RV/TLV ≥ 30%	RVBWR ≥ 0.65	RVBWR ≥ 0.65
Non-concordant	Concordant	Non-concordant	Concordant
6/8	59/63	4/6	60/65
75%	94%	67%	92%

¹incl. 2 remnants with RVBWR = 0.60;

²incl. 1 remnant with RVBWR = 0.60. SFS: Small-for-size; RV/TLV: Remnant volume percentage of total liver volume; RVBWR: Remnant volume (donor) body weight ratio.

Table 3 Comparison of early postoperative biochemical liver function markers among right graft donors (n = 71)

	Remnants	Remnants	Remnants	Remnants
Peak (mean ± SD)	MHV	Non-MHV	RV/TLV ≥ 30%	RV/TLV < 30%
	n = 12	n = 59	n = 65	n = 6
Bilirubin (0.2-1.2)	4.26 ± 2.86	5.54 ± 7.89	4.39 ± 3.92	5.1 ± 2.9
	P = 0.544		P = 0.27
INR (1.0)	1.99 ± 0.52	2.15 ± 0.83	1.87 ± 0.44	2.02 ± 0.57
	P = 0.9		P = 0.587

RV/TLV: Remnant volume percentage of total liver volume; MHV: Middle hepatic vein; INR: International normalized ratio; Bili: Total bilirubin (reference value 0.2-1.2).

Table 4 Middle hepatic vein management in small-for-size -remnants with remnant-volume (donor) body-weight-ratio ≤ 0.65

Donor	Remnant	Remnant	Remnant	Remnant	Remnant	Remnant CV-index	Remnant nc-RVBWR	SFSS
n = 71	Total MHV	MHV-4A	volume	RV/TLV	RVBWR		(LHV)
	preserved	preserved
1	Yes	Yes	434 mL	35%	0.63	37.9%	0.38	Yes
2	No	No	584 mL	31%	0.65	40.2%	0.39	Yes
3	No	No	512 mL	32.9%	0.62	40.0%	0.40	No
4	No	No	500 mL	31.7%	0.64	37.2%	0.38	No
5	No	Yes	429 mL	35.1%	0.60	67.9%	0.20	No
6	No	No	506 mL	38%	0.65	14.8%	0.57	No
7	No	Yes	536 mL	35.6%	0.62	43.4%	0.27	No
8	No	No	505 mL	32%	0.63	39.4%	0.49	No
9	No	No	389 mL	28%	0.60	24.4%	0.41	No
10	Yes	Yes	464 mL	28.2%	0.60	55.4%	0.20	No

SFS: Small-for-size; SFSS: Small-for-size syndrome; LDLT: Live donor liver transplantation; MHV: Middle hepatic vein; MHV-4A: Branch of MHV draining left medial sector; LHV: Left hepatic vein; RVBWR: Remnant-volume (donor) body-weight-ratio; Non-congestive-(nc)-RVBWR: Volume safely drained by LHV; RV/TLV: Remnant volume percentage of total (donor) liver volume; CV-index: Potential congestion volume percentage of remnant liver volume.