Introduction:The fundamental principle in LDLT lies in the fact that it should provide enough liver volume with a safe remnant.The main pretext for safe donor hepatectomy is based primarily on liver's ability to regenerate. In our study we have analyzed prospectively collected imaging data in 23 donors for volumetric recovery in the early regenerative phase (4 weeks).

Materials and Methods: Between March 2013 and September 2016 we performed 137 LDLT. This is a prospectively maintained CECT data which was retrospectively analyzed for volumetric regeneration in 23 donors. Twenty three donors underwent 29 CECT abdomen for various clinical indications at different time frames. The following variables were included: Donor age, sex, BMI, LAI, duration between scans, TLV, pre-op remnant volume, regenerated volumes at various time frames, Absolute Volume Growth% and volumetric recovery %. Liver regeneration was studied by dividing time frame into weekly aliquots. Liver volumes were calculated using Myrian (R) XP-intrasense1.18.0 software and compared with pre transplant remnant volume.

Results:The mean age of the donors were 36.9±11.2 (Range: 20- 58 yrs), out of these 13(56%) were female and 10 male (44%).The mean age of the donors were 36.9±11.2 (Range: 20- 58 yrs), out of these 13(56%) were female and 10 male (44%). The mean BMI of the donors was 24.9±4.0 (Range: 17.7-32.8) and their mean LAI was 8.7±6.5. Liver volumetric recovery in the first week after donor hepatectomy was 58.11± 20 % of the original TLV [one (4.34%) of the donor attained 90 % of TLV] & their absolute growth was 37.6%. Within 2^nd post-op week, the mean volumetric recovery was 71.9 ± 18.3% and absolute growth was 92% of the remnant. In the 2^nd week, volumetric recovery in 17% (4/23) patients was ≥ 90% of TLV and absolute growth was ≥100% in 30% (7/23) of the patients. At the end of 3^rd week, 43% (10/23) patients attain ≥ 80% and 21% (5/23) patients attained ≥ 90% of volumetric recovery. There was one (4.3%) patient in this group who had ≥110% volumetric recovery within 3 weeks after donor hepatectomy. By 4^th week, 47.82% (11/23) patients had ≥80% volumetric recovery and 30.43% (7/23) patients had ≥ 90% volumetric recovery. Two (8.69%) patient in this group had ≥110 % volumetric recovery.

Conclusion: Our study shows complete volumetric recovery can occur in donors as early as 3 to 4 weeks.

CITATION INFORMATION: Sable S, Maheshwari S, Jadhav R, Yadav K, Sharma S, Kumar S, Chouhan A, Kapoor S, Varma V, Kumaran V. Kinetics of Liver regeneration in Donors After Living Donor Living Transplant. Am J Transplant. 2017;17 (suppl 3).

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