GRAFT SIZE ASSESSMENT AND ANALYSIS OF DONORS FOR LIVING DONOR LIVER TRANSPLANTATION USING RIGHT LOBE 1,2

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Abstract
Modality of living donor liver transplantation (LDLT) hasbeen expanded to adult cases. However, the safety of right lobectomy fromliving donors has not yet beenproven. A total of 62 cases of LDLT, using the right lobe, werereviewed. Study 1: Discrepancy between estimated graft volume and actual graftweight was evaluated. Study 2: Postoperative liver functions were analyzed inrelation to residual liver volume (RLV) or age. Residual liver volume ofdonors was defined using two indices, (RLV = estimated whole livervolume − estimated graft volume and %RLV = RLV/estimated wholeliver volume×100). Donors were divided into two groups on the basis ofeither %RLV (<40%; 40%≤) or age (<50 years old; 50 years old≤).Study 3: Right lobe donors were compared with left lobe donors (35 cases) interms of their postoperative liverfunctions. Study 1: The relationship between estimated graft volumeand actual graft weight was linear (y=159.136+0.735x,R 2 =0.571, P <0.001). Study 2: %RLV ranged from23.5% to 55.8% (mean±SD: 43.2±6.0). Fifteen cases showed %RLVless than 40%. Postoperative bilirubin clearance was delayed in that group(%RLV<40%). Serum total bilirubin values on postoperative day 7 in theolder group (age ≥50) were significantly higher than those in the youngergroup (age<50). Study 3: Postoperative liver functions of right lobe donorswere significantly higher than those of left-lobe donors. Eleven donors(17.7%) had surgical complications, all of which were cured with propertreatment. Right lobectomy from living donors is a safe procedure withacceptable morbidity, but some care should be taken early after the operationfor donors with small residual liver and ageddonors.