Estimation of standard liver volume for liver transplantation in the Korean population

Abstract

The standard liver volume (LV) of a recipient is estimated in liver transplantation to determine the minimum LV necessary for the recipient. Simple linear formulas of LV estimation were developed for the Japanese and Caucasian populations. The present study examined the applicability of the reported formulas to the Korean population. Liver density (LD) was determined by analyzing 24 healthy livers. Data of liver weight (LW), body weight (BW), body height (BH), body surface area (BSA), and age were obtained from 652 postmortem examination reports (age, 42.4 +/- 16.5 years) showing normal livers. The LV of each subject was estimated by LW/LD and the relationships between LV, BW, BSA, and age were analyzed. LD was 1.04 +/- 0.07 kg/L. LV/BW decreased as age increased in the children but leveled off in the adults; the rate of increase in LV along with BSA in individuals with BSA < 1.2 m(2) appeared less than the corresponding rate in individuals with BSA greater than or equal to 1.2 m(2). The Japanese formula produced underestimates for the Korean population (226.9 +/- 289.4 mL), while the Caucasian formula produced random errors (-30.64 +/- 281.5 mL). A better LV estimation formula was established: LV (mL) = 21.585 x BW (kg)(0.732) x BH (cm)(0.225) (adjusted R-2 = 0.59; SE = 275.8 mL). In conclusion, this study indicates that a nonlinear or piecewise linear model is more desirable than a simple linear model for LV estimation in children and adults, because LV/BW and LV/BSA are not constant with age and BSA.