L-[1-
                    13
                    C] phenylalanine breath test for monitoring hepatic function after living donor liver transplant surgery

Aims & Objectives: Corner stone in performing living donor liver transplant is to assess and predict the adequacy of the donated liver for recipient and remaining liver. Previously the conversion of liver volume to estimated weight is done by using unit to unit conversion with a factor of 1. We analyzed data of our institute to research the methodology and local applicability of the same. Place and duration of study: Shaikh Zayed Hospital, Lahore. January 2011 to June 2017 Material & Methods: Retrospective data was collected for the first 115 recipients and donors. Their preoperative liver volumes calculated by C.T scan and post-operative graft harvested with weights were compared. Results: The parameter of actual volume of right lobe averaged to 769.77 ± 12.73 gm varying with a quantum of 17.73% (426 – 1123 gm). Estimated volume of right lobe of liver varied 358 to 1218 ml (CV = 17.84%) with an average value of 798.96 ± 13.29 ml. Results of linear regression between estimated volume of right lobe and actual weight of the right lobe in gm was significantly linear (r = 0.830, r2 = 0.690, adj. r2 = 0.689 and F = 250.98, p < 0.0001), showing that volumetric assessment overestimated graft weight/volume. Following is equation generated from our data for graft weight estimation. Actual right lobe (g) = 134.004 + 0.796 (estimated right lobe volume (ml) ± 76.42. Conclusion: Using one to one principle for volume estimation of healthy liver can be misleading and therefore we propose an equation to reach more accurate estimation of graft weight. Keywords: living donor liver transplant, CT volumetry, graft to body weight ratio

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Outcomes of Right and Left Hepatic Arterial Anastomosis in Right Lobe Living Donor Liver Transplant

Experimental and Clinical Transplantation ◽

10.6002/ect.2020.0309 ◽

2021 ◽

Author(s):

Bhargava Ram Chikkala ◽

Rahul Rahul ◽

Shaleen Agarwal ◽

Aarathi Vijayashanker ◽

Yuktansh Pandey ◽

...

Keyword(s):

Liver Transplant ◽

Living Donor ◽

Donor Liver ◽

Living Donor Liver Transplant ◽

Arterial Anastomosis ◽

Right Lobe ◽

Donor Liver Transplant

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Effectiveness of White test versus conventional saline test in minimizing biliary leak in partial liver resection in living donor liver transplant

QJM ◽

10.1093/qjmed/hcab097.032 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Amr Ahmed Abd-Elaal Mahmoud ◽

Hatem Sayed Saber ◽

Mahmoud Mohamed Elsayed Ibrahim

Keyword(s):

Liver Resection ◽

Liver Transplant ◽

Living Donor ◽

Bile Leakage ◽

Donor Liver ◽

Partial Liver Resection ◽

Living Donor Liver Transplant ◽

White Test ◽

Donor Liver Transplant ◽

Saline Test

Abstract Background Intra-operative bile leakage testing is very important in partial liver resection in living donor liver transplant as it allows detection of bile leaking points on the cut surface and decreases postoperative bile leak which is one of the most dreadful complication following liver transplant surgery. In this study we tried to assess the Effectiveness of White test versus conventional saline test in minimizing biliary leak in partial liver resection in living donor liver transplant. Objective In this study, we assess whether the White test is better than the conventional saline test for the intraoperative detection of biliary leakage in patients who will undergo partial liver resection as living donor liver transplant. Methodology In this study, we assess whether the White test is better than the conventional saline test for the intraoperative detection of bile leakage in patients who underwent partial liver resection as a living donor liver transplant. This study included 60 patients who received partial liver resection as a living donor liver transplant. The conventional saline test (injecting an isotonic sodium chloride solution through the cystic duct) was carried out in 30 patients and the White test (injecting a fat emulsion solution through the cystic duct) was carried out in 30 patients Results Incidence of postoperative bile leakage was compared between the conventional method and the White test. Bile leakage occurred in 8 patients (26.7%) in the conventional method group and in 2 patients (6.7%) in the White test group. In addition, the White test detected intraoperative a significantly higher number of bile leakage sites compared with the conventional method. The White test is better than the conventional test for the intraoperative detection of bile leakage. Conclusion Based on our study, we recommend that surgeons investigating bile leakage sites during liver resections should use the White test instead of the conventional saline test.

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