Portal venous velocity affects liver regeneration after right lobe living donor hepatectomy

PLoS One. 2018 Sep 17;13(9):e0204163. doi: 10.1371/journal.pone.0204163. eCollection 2018.

Abstract

Objectives: We investigated whether chronological changes in portal flow and clinical factors play a role in the liver regeneration (LR) process after right donor-hepatectomy.

Materials and methods: Participants in this prospective study comprised 58 donors who underwent right donor-hepatectomy during the period February 2014 to February 2015 at a single medical institution. LR was estimated using two equations: remnant left liver (RLL) growth (%) and liver volumetric recovery (LVR) (%). Donors were classified into an excellent regeneration (ER) group or a moderate regeneration (MR) group based on how their LR on postoperative day 7 compared to the median value.

Results: Multivariate analysis revealed that low residual liver volume (OR = .569, 95% CI: .367- .882) and high portal venous velocity in the immediate postoperative period (OR = 1.220, 95% CI: 1.001-1.488) were significant predictors of LR using the RLL growth equation; high portal venous velocity in the immediate postoperative period (OR = 1.325, 95% CI: 1.081-1.622) was a significant predictor of LR using the LVR equation. Based on the two equations, long-term LR was significantly greater in the ER group than in the MR group (p < .001).

Conclusion: Portal venous velocity in the immediate postoperative period was an important factor in LR. The critical time for short-term LR is postoperative day 7; it is associated with long-term LR in donor-hepatectomy.

MeSH terms

  • Adult
  • Blood Flow Velocity
  • Female
  • Hepatectomy*
  • Humans
  • Liver / growth & development
  • Liver / surgery
  • Liver Regeneration / physiology*
  • Living Donors*
  • Logistic Models
  • Male
  • Portal Vein / physiology*
  • Preoperative Care

Grants and funding

This study received no funding.