韩国成人标准肝体积计算及混杂变量分析

Eun Hae Um, Shin Hwang, G. Song, D. Jung, C. Ahn, Ki‐Hun Kim, D. Moon, G. Park, Sung‐Gyu Lee
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引用次数: 28

摘要

背景/目的标准肝体积(Standard liver volume, SLV)是活体肝移植(living donor liver transplantation, LDLT)中评估移植物匹配的重要参考参数。本研究旨在与其他研究的15种SLV配方进行比较,确定适用于韩国成年患者的可靠SLV配方,并进一步根据性别和体重指数(BMI)估计SLV配方。方法对1000例活体供体进行肝容量ct测量,计算肝容量的回归公式。将个体供体数据应用于先前发表的15个SLV公式,并与本研究得出的SLV公式进行比较。对BMI和性别的混杂变量也进行了分析。结果利用本研究纳入的1000例活体供体的资料,分别推导出DuBois体表面积公式“SLV (ml)=908.204×BSA-464.728”和Monsteller体表面积公式“SLV (ml)=893.485×BSA-439.169”两个公式。与其他15个公式比较,除Chouker公式外,其余公式的平均体积百分比误差均在4.8-5.4%之间。性别对总肝体积(TLV)无显著影响,但随着BMI的增加,总肝体积显著增加。结论本研究表明,大多数SLV公式对韩国成年人的SLV估计具有粗略的适用范围。考虑到估计SLV的体积误差,应进一步开展来自多个中心的更大人群的SLV研究,以提高其可预测性。我们的研究结果表明,没有必要将SLV配方按BMI和性别进行分类。
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Calculation of standard liver volume in Korean adults with analysis of confounding variables
Backgrounds/Aims Standard liver volume (SLV) is an important parameter that has been used as a reference value to estimate the graft matching in living donor liver transplantation (LDLT). This study aimed to determine a reliable SLV formula for Korean adult patients as compared with the 15 SLV formulae from other studies and further estimate SLV formula by gender and body mass index (BMI). Methods Computed tomography liver volumetry was performed in 1,000 living donors for LDLT and regression formulae for SLV was calculated. Individual donor data were applied to the 15 previously published SLV formulae, as compared with the SLV formula derived in this study. Analysis for confounding variables of BMI and gender was also performed. Results Two formulae, "SLV (ml)=908.204×BSA-464.728" with DuBois body surface area (BSA) formula and "SLV (ml)=893.485×BSA-439.169" with Monsteller BSA formula, were derived by using the profiles of the 1,000 living donors included in the study. Comparison with other 15 other formulae, all except for Chouker formula showed the mean volume percentage errors of 4.8-5.4%. The gender showed no significant effect on total liver volume (TLV), but there was a significant increase in TLV as BMI increased. Conclusions Our study suggested that most SLV formulae showed a crudely applicable range of SLV estimation for Korean adults. Considering the volume error in estimating SLV, further SLV studies with larger population from multiple centers should be performed to enhance its predictability. Our results suggested that classifying SLV formulae by BMI and gender is unnecessary.
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