Analysis of factors associated with discrepancies between predicted and observed liver weight in liver transplantation

Liver International - Tập 41 Số 6 - Trang 1379-1388 - 2021
Pietro Addeo1,2, Benoît Naegel2, Alfonso Terrone1, François Faitot1,2, Caroline Schaaf1, Philippe Bachellier1, Vincent Noblet2
1Hepato‐Pancreato‐Biliary Surgery and Liver transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation Hôpital de Hautepierre‐Hôpitaux Universitaires de Strasbourg, Université de Strasbourg Strasbourg France
2ICube, Université de Strasbourg, CNRS UMR 7357, Illkirch, France

Tóm tắt

AbstractBackgroundEven using predictive formulas based on anthropometrics in about 30% of subjects, liver weight (LW) cannot be predicted with a ≤20% margin of error. We aimed to identify factors associated with discrepancies between predicted and observed LW.MethodsIn 500 consecutive liver grafts, we tested LW predictive performance using 17 formulas based on anthropometric characteristics. Hashimoto's formula (961.3 × BSA_D‐404.8) was associated with the lowest mean absolute error and used to predict LW for the entire cohort. Clinical factors associated with a ≥20% margin of error were identified in a multivariable analysis after propensity score matching (PSM) of donors with similar anthropometric characteristics.ResultsThe total LW was underestimated with a ≥20% margin of error in 53/500 (10.6%) donors and overestimated in 62/500 (12%) donors. After PSM analysis, ages ≥ 65, (OR = 3.21; CI95% = 1.63‐6.31; P = .0007), age ≤ 30 years, (OR = 2.92; CI95% = 1.15‐7.40; P = .02), and elevated gamma‐glutamyltransferase (GGT) levels (OR = 0.98; CI95% = 0.97‐0.99; P = .006), influenced the risk of LW overestimation. Age ≥ 65 years, (OR = 5.98; CI95% = 2.28‐15.6; P = .0002), intensive care unit (ICU) stay with ventilation > 7 days, (OR = 0.32; CI95% = 0.12‐0.85; P = .02) and waist circumference increase (OR = 1.02; CI95% = 1.00‐1.04; P = .04) were factors associated with LW underestimation.ConclusionsIncreased waist circumference, age, prolonged ICU stay with ventilation, elevated GGT were associated with an increase in the margin of error in LW prediction. These factors and anthropometric characteristics could help transplant surgeons during the donor–recipient matching process.

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Liver International

Tập 41 Số 6

1379-1388

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