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


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


In Press

04 Aug 2022 : Original article  

Long-Term Patency of All-in-One Sleeve Patch Graft Venoplasty in 16 Patients Who Underwent Living Donor Liv...

Ann Transplant In Press; DOI: 10.12659/AOT.936888  

22 Jul 2022 : Original article  

Diagnostic Role of Tumor Markers for Hepatocellular Carcinoma in Liver Transplantation Candidates: An Analy...

Ann Transplant In Press; DOI: 10.12659/AOT.936937  

22 Jul 2022 : Original article  

Development of a Novel Model for Predicting Postoperative Short-Term Outcome in Patients with Hepatitis B-R...

Ann Transplant In Press; DOI: 10.12659/AOT.936732  

22 Jul 2022 : Original article  

Leucine-Rich Alpha-2-Glycoprotein (LRG-1) as a Potential Kidney Injury Marker in Kidney Transplant Recipients

Ann Transplant In Press; DOI: 10.12659/AOT.936751  

Most Viewed Current Articles

26 Jan 2022 : Review article  

Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models

DOI :10.12659/AOT.934924

Ann Transplant 2022; 27:e934924

29 Dec 2021 : Original article  

Efficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...

DOI :10.12659/AOT.933588

Ann Transplant 2021; 26:e933588

24 Jul 2020 : Review article  

Kidney Transplantation in the Times of COVID-19 – A Literature Review

DOI :10.12659/AOT.925755

Ann Transplant 2020; 25:e925755

15 Mar 2022 : Case report  

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

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