1: Hepatology 1995 May;21(5):1317-21

Calculation of child and adult standard liver volume for liver transplantation

Urata K, Kawasaki S, Matsunami H, Hashikura Y, Ikegami T, Ishizone S, Momose Y,
Komiyama A, Makuuchi M
First Department of Surgery, Shinshu University School of Medicine, Matsumoto,
Japan

Abstract
Despite refinements in surgical techniques for liver transplantation, liver size
disparity remains one of the most common problems in pediatric patients. Optimal
liver graft size remains unknown and the volume of diseased liver in the
recipient is not indicative of the volume (standard liver volume [LV]) optimal
for the recipient's metabolic demands. To establish a formula for calculating
the standard LV in the pediatric and adult populations for liver
transplantation, whole LVs were measured using computed tomography (CT) in 96
patients (65 pediatric and 31 adolescent or adult subjects) with normal liver
whose disease conditions did not seem to affect body weight (BW) or LV. In the
96 subjects, the ratio of estimated LV to BW decreased gradually as age
increased until approximately 16 years, when it started to level off. On the
other hand, there seemed to be a directly proportional relationship between the
estimated LV in vivo and body surface area (BSA) (r = .981; r2 = .962; P <
.0001) in the subjects as a whole, and the formula, LV (mL) = 706.2 x BSA (m2) +
2.4, was established from the measured data by simple regression analysis.
Another predicting equation, LV (mL) = 2.223 x BW (kg)0.426 x body height (BH)
(cm)0.682, was produced by multiple regression analysis (r2 = .969; P < .0001).
Considering its simplicity of use, we adopted the first formula for predicting
standard LV in an individual patient