Assessment of the regenerative capacity of the remnant liver lobe in livng-related donors after right hemihepatectomy
DOI:
https://doi.org/10.14739/2310-1210.2025.5.340579Keywords:
donors, liver, right hepatectomy, CT volumetry, liver regenerationAbstract
Donor right hepatectomy is the standard method of graft procurement in living-related donors. Donor safety depends on adequate regeneration of the remnant liver. Studying the patterns of parenchymal regeneration and functional liver reserve in this category of patients has important clinical significance.
Aim. To evaluate the regenerative capacity of the remnant liver in living-related donors after right hepatectomy.
Materials and methods. A prospective study was conducted including 50 living liver donors who underwent right hepatectomy. Liver volumes were assessed using CT volumetry preoperatively and on postoperative days 14 and 90. The study was conducted in accordance with the principles of the Declaration of Helsinki. The protocol was approved by the institutional bioethics committee, and informed consent was obtained from all participants
Results. The mean remnant liver volume was 448.7 ± 93.9 ml preoperatively, 833.0 ± 176.1 ml on day 14, and 943.2 ± 160.3 ml on day 90. A statistically significant increase was observed on both day 14 and day 90 (p < 0.001). The increase relative to baseline was +85.6 % at day 14 and +110.2 % at day 90.
Conclusions. The liver of living donors demonstrates a high regenerative potential after right hepatectomy, with restoration of adequate parenchymal volume within the first three months postoperatively.
References
Tsang LL, Chen CL, Huang TL, Chen TY, Wang CC, Ou HY, et al. Preoperative imaging evaluation of potential living liver donors: reasons for exclusion from donation in adult living donor liver transplantation. Transplant Proc. 2008;40(8):2460-2. doi: https://doi.org/10.1016/j.transproceed.2008.07.075
Jeong SY, Lee J, Kim KW, Jang JK, Kwon H-J, Song GW, et al. Estimation of the right posterior section volume in live liver donors: Semiautomated CT volumetry using portal vein segmentation. Acad Radiol. 2020;27(2):210-8. 10.1016/j.acra.2019.03.018
Park R, Lee S, Sung Y, Yoon J, Suk HI, Kim H, et al. Accuracy and Efficiency of Right-Lobe Graft Weight Estimation Using Deep-Learning-Assisted CT Volumetry for Living-Donor Liver Transplantation. Diagnostics (Basel). 2022;12(3):590. doi: https://doi.org/10.3390/diagnostics12030590
Zhang Y, Li B, He Q, Chu Z, Ji Q. Comparison of liver regeneration between donors and recipients after adult right lobe living-donor liver transplantation. Quant Imaging Med Surg. 2022;12(6):3184-92. doi: https://doi.org/10.21037/qims-21-1077
Kim M, Suh SW, Lee ES, Suh S, Lee SE, Choi YS. Clinical Factors Affecting the Rate of Liver Regeneration in Living Donors after Right Hepatectomy. J Pers Med. 2024;14(5):458. doi: https://doi.org/10.3390/jpm14050458
Michalopoulos GK, Bhushan B. Liver regeneration: biological and pathological mechanisms and implications. Nat Rev Gastroenterol Hepatol. 2021;18(1):40-55. doi: https://doi.org/10.1038/s41575-020-0342-4
Wang WC, Wu TH, Hung HC, Lee JC, Cheng CH, Wang YC, et al. Liver regeneration of living donor after liver donation for transplantation: Disparity in the left and right remnant liver. Medicine (Baltimore). 2024;103(14):e37632. doi: https://doi.org/10.1097/MD.0000000000037632
Khalid A, Khan BA, Saeed Z, Khan MY, Rashid S, Haq IU, et al. 301.9: Correlating CT volumetry with actual graft volume in living donor liver transplantation: A retrospective analysis. Transplantation. 2024;108(9S). doi: https://doi.org/10.1097/01.tp.0001065196.43278.e8
Olthoff KM, Emond JC, Shearon TH, Everson G, Baker TB, Fisher RA, et al. Liver regeneration after living donor transplantation: adult-to-adult living donor liver transplantation cohort study. Liver Transpl. 2015;21(1):79-88. 10.1002/lt.23966
Haga J, Shimazu M, Wakabayashi G, Tanabe M, Kawachi S, Fuchimoto Y, et al. Liver regeneration in donors and adult recipients after living donor liver transplantation. Liver Transpl. 2008;14(12):1718-24. doi: https://doi.org/10.1002/lt.21622
Dehlke K, Krause L, Tyufekchieva S, Murtha-Lemekhova A, Mayer P, Vlasov A, et al. Predicting liver regeneration following major resection. Sci Rep. 2022;12(1):13396. doi: https://doi.org/10.1038/s41598-022-16968-9
Hou CT, Chen YL, Lin CC, Chou CT, Lin KH, Lin PY, et al. Portal venous velocity affects liver regeneration after right lobe living donor hepatectomy. PLoS One. 2018;13(9):e0204163. doi: https://doi.org/10.1371/journal.pone.0204163
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205-13. doi: https://doi.org/10.1097/01.sla.0000133083.54934.ae
Downloads
Additional Files
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 I. O. Kotenko, O. I. Dronov

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. 