Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

26 January 2015 : Original article  

Postoperative Assessment of Hepatic Asialoglycoprotein Receptor Function with Tc-99m GSA: The Safety Margin of Resection Size in Living Donor Liver Transplantation

Kentaro KobayashiABCDEF, Naoya HattoriABCDEF, Osamu ManabeABCDF, Kenji HirataABCDF, Keiichi MagotaB, Tsuyoshi ShimamuraABE, Nagara TamakiE

DOI: 10.12659/AOT.892490

Ann Transplant 2015; 20:51-58

Abstract

BACKGROUND: Living liver donation is associated with size-dependent complications. The resectable size and its safety margin should be defined for the safety of donors. The purpose of the present study was to determine if the current partial hepatectomies are done under the safety margin of the resectable size, by measuring asialoglycoprotein receptor (ASGPR) function of donor’s remnant liver.

MATERIAL AND METHODS: Seventy-four living donors (age 35±11 years) underwent Technetium-99m-diethylenetriaminepentaacetic acid-galactosyl-human serum albumin (Tc-99m GSA) scintigraphy at postoperative week 1. We evaluated the scintigraphic results using established parameters of GSA uptake (LHL15) and its clearance from the blood pool (HH15). Based on the literature, we consider HH15 <0.55 to indicate normal ASGPR function, and 0.55£ HH15 <0.65 to indicate mild impairment. In terms of the hepatic uptake, we consider LHL15>0.93 to indicate normal ASGPR function, and 0.87< LHL15 £0.93 to indicate mild impairment.

RESULTS: The average resected size was 337±170 mL, corresponding to 28±12% of the original donor’s whole liver volume. No donors showed 0.65≤ HH15 or LHL15 <0.87, suggesting moderate or severely impaired ASGPR function. However, larger resection size (35–53%) was positively associated with higher HH15 values (R=0.53, p<0.001). In the range of HH15 (0.35–0.64) among present donors, higher HH15 values did not affect the regeneration volume (R=0.03, p=NS).

CONCLUSIONS: Larger partial resection (≥35% of the original liver volume) may impair postsurgical ASGPR function, but smaller resection (<35%) was considered to be under the safety margin of the hepatectomy. Although mildly impaired postsurgical ASGPR function did not indicate poor prognosis, careful attention may be required for donors undergoing larger (³35%) partial resection.

Keywords: Asialoglycoprotein Receptor, Hepatectomy, Liver Function Tests, Liver Regeneration, Liver Transplantation, Living Donors

Add Comment 0 Comments

In Press

Original article  

Steroid Use in ABO-Incompatible Kidney Transplants: Withdrawal vs Maintenance

Ann Transplant In Press; DOI: 10.12659/AOT.947747  

Original article  

Intra-Arterial Contrast-Enhanced Ultrasound for Transcatheter Thrombolysis in Post-Transplant Hepatic Arter...

Ann Transplant In Press; DOI: 10.12659/AOT.947500  

Original article  

Early Atropine Protocol Enhances Dobutamine Stress Echocardiography in End-Stage Liver Disease: A Practical...

Ann Transplant In Press; DOI: 10.12659/AOT.950166  

Most Viewed Current Articles

15 Aug 2023 : Review article   7,349

Free-Circulating Nucleic Acids as Biomarkers in Patients After Solid Organ Transplantation

DOI :10.12659/AOT.939750

Ann Transplant 2023; 28:e939750

03 Jan 2023 : Original article   7,212

Impact of Autologous Stem Cell Transplantation on Primary Central Nervous System Lymphoma in First-Line and...

DOI :10.12659/AOT.938467

Ann Transplant 2023; 28:e938467

16 May 2023 : Original article   7,034

Breaking Antimicrobial Resistance: High-Dose Amoxicillin with Clavulanic Acid for Urinary Tract Infections ...

DOI :10.12659/AOT.939258

Ann Transplant 2023; 28:e939258

28 May 2024 : Original article   6,633

Effect of Dexmedetomidine Combined with Remifentanil on Emergence Agitation During Awakening from Sevoflura...

DOI :10.12659/AOT.943281

Ann Transplant 2024; 29:e943281

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358