# Clinical Factors Affecting the Rate of Liver Regeneration in Living Donors after Right Hepatectomy

## TL;DR

This study examines how clinical factors influence liver regeneration in living donors after right hepatectomy, finding that lower remnant liver volume leads to more compensatory regeneration.

## Contribution

The study identifies RTVR and intraoperative blood loss as significant predictors of liver regeneration rates in living donors.

## Key findings

- Group A (RTVR < 30%) showed significantly greater residual liver volume growth at Postoperative Week 1 compared to Group B.
- RTVR and intraoperative blood loss were significant predictors of liver regeneration rates.
- Lower remnant liver volume leads to more compensatory regeneration, resulting in comparable operative outcomes.

## Abstract

Sufficient liver regeneration after a right hepatectomy is important in living donors for preventing postoperative hepatic insufficiency; however, it differs for each living donor so we investigated the clinical factors affecting the rate of liver regeneration after hepatic resection. This retrospective case–control study investigated fifty-four living donors who underwent a right hepatectomy from July 2015 to March 2023. Patients were classified into 2 groups by the remnant/total volume ratio (RTVR): Group A (RTVR < 30%, n = 9) and Group B (RTVR ≥ 30%, n = 45). The peak postoperative level of total bilirubin was more elevated in Group A than in Group B (3.0 ± 1.1 mg/dL vs. 2.3 ± 0.8 mg/dL, p = 0.046); however, no patients had hepatic insufficiency or major complications. The rates of residual liver volume (RLV) growth at Postoperative Week 1 (89.1 ± 26.2% vs. 53.5 ± 23.7%, p < 0.001) were significantly greater in Group A, and its significant predictors were RTVR (β = −0.478, p < 0.001, variance inflation factor (VIF) = 1.188) and intraoperative blood loss (β = 0.247, p = 0.038, VIF = 1.182). In conclusion, as the RLV decreases, compensatory liver regeneration after hepatic resection becomes more prominent, resulting in comparable operative outcomes. Further studies are required to investigate the relationship between hematopoiesis and the rate of liver regeneration.