Background: After pediatric liver transplantation, the grafted liver is thought to grow as the patient grows. Although lateral hepatic segment grafts are commonly used in infants and young children, there are no reports on how lateral segment grafts expand with the growth of the body. This time, we measured the liver volume in a long-term case after pediatric liver transplantation, and we will compare it with the standard liver volume and report it.
Patients and methods: The subjects were 22 cases of pediatric liver transplantation performed at Juntendo University from 2002 to 2016. In 13 of these cases, abdominal CT was taken 29 times during follow-up, and the volume of the transplanted liver was measured using FUJIFILM SYNAPSE VINCENT. Standard liver volume was calculated using the formula reported by URATA (1995), NODA (1997), YANG (2021), et al., and the ratio of graft liver volume to standard liver volume (GV/SLV) was determined. Portal vein occlusion (PVO) due to thrombosis was observed in two cases, and a comparison was made between these two cases (PVO group) and other cases (Normal group).
Results: The median age at the time of CT scan was 6.5 years (IQR 3.5 - 9.0), and the median weight was 19.5 kg (IQR 14.8 - 26.0). GV/SLV was 1.14±0.20 in the Normal group using the URATA formula and 0.85±0.07 in the PVO group (p<0.01), 1.23±0.23 in the Normal group using the NODA formula and 0.85±0.08 in the PVO group (p<0.01), and 1.19 in the Normal group using the YANG formula. The graft volume was significantly smaller in the PVO group in both cases: ±0.23 and 0.89±0.07 in the PVO group (p<0.01). There was no correlation between the GV/SLV ratio during the long-term course and the GV/SLV ratio at the time of liver transplantation.
Conclusion: We found that liver transplant grafts (lateral segment grafts) during infancy increased in size by 1.14 times the standard liver volume (Urata formula). Patients with portal vein occlusion tended to have smaller liver volumes. Since there was almost no data after the age of 18, it is necessary to collect more data in the future.