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Kinetics of liver regeneration in donors after living donor liver transplantation: A retrospective analysis of “2/3rd partial hepatectomy” model at 3 months

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Abstract

Background/Aim

Right lobe living donor (2/3rd partial hepatectomy) model is the best way to accurately study liver regeneration process in human beings. We aimed to study the kinetics of liver regeneration after 2/3rd partial hepatectomy in donors.

Methods

Retrospective analysis of prospectively maintained volumetric recovery data in donors was performed in 23 donors, who underwent 29 contrast-enhanced computed tomography within 3 months for various clinical indications.

Results

The absolute volumetric growth percentages were as follows: 37.60 ± 21.74 at 1st week, 92 ± 53.27 at 2nd week, 115.55 ± 59.65 at 4th week, and 110.79 ± 64.47 at 3 months. On sub-group analysis of our cohort, we found that 4.3%, 17%, 30.4%, and 39% donors attended ≥ 90% volumetric recovery at 1st, 2nd, 4th week, and 3 months, respectively. One patient at 4th week revealed 128% volumetric recovery. There was one more patient who exceeded original total liver volumes (TLV) (111% of TLV) at 2.5 months. The serum bilirubin and INR values peaked at postoperative day (POD) 3rd and then started showing a downward trend from POD 5th onwards.

Conclusion

Our study is the first to document complete volumetric recovery in donors as early as 3 weeks. Two of the donors overshot their original TLV during the early regenerative phase.

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Acknowledgements

We would like to express our gratitude and thanks to Dr. Agrima Gera, Dr. Nilesh Gumardhar, and Mr. Rahul Jadhav for their support till completion of this article.

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Authors and Affiliations

  1. Department of Liver Transplantation and HPB Surgery, Kokilaben Dhirubhai Ambani Hospital, Mumbai, 400 053, India

    Shailesh Anand Sable, Swapnil Sharma, Kapildev Yadav, Ashutosh Chauhan, Sorabh Kapoor, Vibha Varma & Vinay Kumaran

  2. Department of Radio-Diagnosis, Kokilaben Dhirubhai Ambani Hospital, Mumbai, 400 053, India

    Sharad Maheshwari

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  1. Shailesh Anand Sable
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Contributions

Study concept and protocol design, and initial draft for manuscript: SS and VK, data collection, and volumetric recovery data analysis; SS, SM, SS and KY. Critical revision of manuscript and intellectual content: SS, AC, VV, SK, and VK.

Corresponding author

Correspondence to Shailesh Anand Sable.

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Conflict of interest

SS, SM, SS, KY, AC, SK, VV, and VK declare that they have no conflict of interest.

Ethics statement

The authors declare that the study was performed in a manner conforming to the Helsinki declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

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Sable, S.A., Maheshwari, S., Sharma, S. et al. Kinetics of liver regeneration in donors after living donor liver transplantation: A retrospective analysis of “2/3rd partial hepatectomy” model at 3 months. Indian J Gastroenterol 37, 133–140 (2018). https://doi.org/10.1007/s12664-018-0838-9

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  • DOI: https://doi.org/10.1007/s12664-018-0838-9

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