Measurement of liver volumes by portal vein flow by Doppler ultrasound in living donor liver transplantation

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>The accurate estimation of liver volume and right/left ratio in donor candidates is critical, but there is no method using portal vein (PV) flow.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Of 125 donor candidates, right/left liver volume ratio was estimated using ultrasound (US)‐PV area ratio and Doppler US‐PV flow ratio, and the results were compared with CT volumetry. We analyzed these results in 76 donors who underwent hemihepatectomy. We evaluated diagnostic values of Doppler US‐PV flow for <30% remnant liver volume high‐risk donors, and compared liver volume by Doppler US‐PV flow with actual graft weight.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>In 125 donor candidates, 96.8% showed <10% difference between liver volume ratio by Doppler US‐PV flow ratio and CT volumetry. Compared with CT volumetry, the mean percentage difference of liver volume ratio by Doppler US‐PV flow ratio was significantly smaller than that by US‐PV area ratio (±0.7% vs ±6.3%, <jats:italic>P</jats:italic><.001). In 76 donors who underwent hemihepatctomy, results were similar, showing smaller mean percentage difference of liver volume ratio by Doppler US‐PV flow ratio than that by US‐PV area ratio (±1.0% vs ±6.0%, <jats:italic>P</jats:italic><.001). Sensitivity and specificity for <30% remnant liver volume donors were 76.9% and 76.8%. Blood‐free liver volume by Doppler US‐PV flow was linearly correlated with graft weight (<jats:italic>R</jats:italic><jats:sup>2</jats:sup>=0.770, <jats:italic>P</jats:italic><.001), although significantly different, with 8.5% error ratio (669.3±173.2 vs 633.7±187.1, <jats:italic>P</jats:italic>=.001).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Doppler US‐PV flow can effectively estimate right/left liver volume ratio in initial donor investigation. However, Doppler US‐PV flow is not accurate in assessing donors with <30% remnant liver volume and in estimating actual graft weight.</jats:p></jats:sec>