Introduction: The literature provides differing information about the congruity between volumetric data of hepatic tissue determined preoperatively by using CT and data determined intraoperatively. Volumetric analysis of the liver using computed tomography (CT) datasets has become an important component of the preoperative assessment before major hepatectomy and for living related liver donation. CT images allow determination of the volume of liver tissue required by the recipient and the volume remaining with the donor. In this regard, CT volumetry is necessary for preoperative documentation because the volume of the left lateral segment is quite variable.

Objectives: To determine the relative accuracy of computed tomographic (CT) volumetry for estimation of right-lobe graft weight in living donor liver transplantation by comparing it with actual intraoperative findings.

Materials and Methods: Over the period from January 2009 to January 2011, 40 patients underwent live donor liver transplant using a right lobe liver graft without MHV in the National Liver Institute, Menoufiya University, Egypt. These cases had a contrast material-enhanced CT examination of the abdomen was included in the evaluation and was required for the analysis of morphologic characteristics, the vascular status of the liver, and the evaluation of the hepatic parenchyma. The hepatic venous phase was used for preoperative CT volumetric measurement of the donor liver because, in this phase, the determining hepatic veins are depicted with maximum contrast. The intraoperative graft weight was measured in 40 live liver donors who underwent graft hepatectomy.

Results: Mean of Calculated wt. of graft = 952.35 (n = 40), mean of Actual graft wt = 871.25 (n = 40) with no significant difference. 32 cases out of 40, the calculated weight of the graft is almost the same as or even greater than the actual one which means that we can guarantee donor safety, in the same time, we can also ensure adequacy of the graft for the recipient provided that all the graft to recipient weight ratio (GRWR) were above 0.8, in our series it ranged from a minimum of 0.84 to 1.9 (mean 1.09525+ 0.21). In 8 cases the actual graft weight is more than the calculated one, the percentile difference between both for such cases ranged from (0.53 to 16.66 %) with a median of 1.615 and only two cases (5%) were out of the range (15.78, 16.66). This was also confirmed by comparing the medians of the calculated graft to recipient weight ratio (GRWR) and the actual GRWR (which were 1.1, 1.09 respectively) with no significant difference at all.

Conclusions: Our results demonstrate that the CT Volumetry is an efficient and a reliable tool for assessing LDLT graft weight and volume prediction. The size of the right lobe graft for LDLT can be precisely calculated from preoperative CT Volumetry with confidence and accuracy up to 95%, as it could offer a precise virtual model of individualized graft volumes for each potential live liver donor.