*Purpose: In living donor liver transplantation, donor safety is the top priority.Thus, the debate over how much a donor’s liver can be taken to recipient has continued. In this study, we analyzed factors affecting hepatic volume increase after liver donation and examined their association with postoperative change in bilirubin level.

*Methods: 42 randomly selected liver donors who underwent right hemihepatectomy at Seoul National University Hospital between July 2017 and April 2018 were enrolled. We had all donors check CT scan, MRI and routine lab including LFT before surgery. At 1 week and 4 months after surgery, CT was additionally performed and blood test was checked at POD#1, 2, 3, 5, 7, 21. The software Dr. liver was used to measure liver volume.

*Results: On univariate analysis, remnant Lt. liver volume, height, weight, lean body weight, body surface area and gender showed statistically significant correlationwith hepatic volume increase 1 week after Rt. liver donation. And, remnant Lt. liver volume and MRI fat fraction showed statistically significant correlation withhepatic volume increase 4 months after Rt. liver donation. In multivariate analysis, high lean body weight and low remnant liver volume correlated significantly with hepatic volume increase 1 week after surgery. On the other hand, only low remnant volume had an effect on volume increase after 4 months. And, lean body weight is the only factor significantly associated with peak bilirubin level.

*Conclusions: The indicators for evaluating how much volume should be left in donor surgery are not clearly determined. But, if only bilirubin level were taken into consideration, high lean body weight can be a good indicator of high risk for major hepatectomy. This suggests that the hepatic function required to maintain bioactivity rather than the remaining volume ratio of liver appears to be an important indicator for the hepatic recovery of donor after surgery.

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