Browse

Hypoattenuation in unenhanced CT reflects histological graft dysfunction and predicts 1-year mortality after living donor liver transplantation

Cited 11 time in Web of Science Cited 13 time in Scopus
Authors
Cho, Jai Young; Suh, Kyung-Suk; Lee, Hae Won; Cho, Eung-Ho; Yang, Sung Hoon; Cho, Yong Beom; Yi, Nam-Joon; Kim, Min A; Jang, Ja-June; Lee, Kuhn Uk
Issue Date
2006-05-26
Publisher
John Wiley & Sons
Citation
Liver Transpl. 2006 Sep;12(9):1403-11
Keywords
AdultAgedFemaleHumansLiver/*pathology/*radiographyLiver Transplantation/*mortalityLiving DonorsMaleMiddle AgedRetrospective Studies*Tomography, X-Ray Computed
Abstract
Early postoperative graft function assessments are essential after living donor liver transplantation (LDLT) to predict patient and graft outcome. Computed tomography (CT) is usually used to evaluate various complications and parenchymal abnormalities after LDLT. Here, we attempted to determine the prognostic values of CT attenuation changes of grafts for predicting 1-year patient survival. Liver attenuation indices (LAIs), derived from differences between hepatic and splenic attenuations, were calculated on unenhanced CT images obtained 10 days after LDLT in 62 adult LDLT recipients between September 2002 and August 2004. Patients were assigned to 1 of 2 groups according to LAI value on the 10th postoperative day, as follows: group L (LAI < or = 5, n = 14) or group H (LAI > 5, n = 48). Parenchymal dysfunction scores, summed parameters for histological dysfunction including both portal tract and centrilobular features, were also assessed on the 10th postoperative day using liver biopsy specimens. Histological parenchymal dysfunction, especially in the centrilobular area, in terms of cholestasis, centrilobular necroinflammation, central vein fibrosis, steatosis, mononuclear infiltrates, and hepatocyte ballooning, was more prominent in group L than in group H, while that in the portal area was similar between the 2 study groups. Significant negative linear correlations were observed between LAI and parenchymal dysfunction scores (r = 0.486, P < 0.001). Group L patients showed lower 1-year survival (69.7%) than group H patients (95.8%; P = 0.0002). Moreover, group H patients died with a functioning graft (n = 3), whereas group L patients died of graft failure (n = 6). After multivariate analysis, LAI alone remained independently associated with 1-year mortality (P = 0.014; odds ratio = 0.845; 95% confidence interval, 0.739-0.967). The sensitivity and specificity of LAI were 84.6% and 75%, respectively, and LAI outperformed MELD score as a predictor of 1-year mortality after LDLT by receiver operating characteristic curve analysis. In conclusion, LAI, as determined by unenhanced CT 10 days after LDLT, well predicts 1-year patient survival after LDLT.
ISSN
1527-6465 (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16724340

http://hdl.handle.net/10371/15878
DOI
https://doi.org/10.1002/lt.20772
Files in This Item:
There are no files associated with this item.
Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Surgery (외과학전공)Journal Papers (저널논문_외과학전공)
  • mendeley

Items in S-Space are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse