Prediction of early graft regeneration after pediatric left lateral lobe living donor liver transplantation using CT texture analysis

Abstract

Background Pediatric left lateral lobe living donor liver transplantation (LDLT) is a lifesaving procedure for children with end-stage liver diseases. Understanding the factors that influence and predict the recipients' early liver regeneration rate (LRR) after LDLT is crucial for optimizing post-transplant outcomes. This study aims to predict the recipients' early LRR after pediatric LDLT using CT texture analysis and clinical information. Methods A total of 181 donor-recipient pairs who underwent pediatric left lateral lobe LDLT surgery were retrospectively collected. Preoperative CT of the donors and postoperative CT of the recipients (3 months after LDLT) were performed. The graft LRRs were calculated and compared. CT texture parameters and clinical information were compared between high and low LRR groups. Univariate and multivariate linear regression analysis were used to investigate the correlation between clinical, texture parameters and LRR, and to create the optimal LRR prediction equation. Results The postoperative early graft LRR was 24.38 ± 30.84% (-42.99% -107.11%). There were significant differences in 9 clinical parameters and 8 CT texture features between the two groups (all P < 0.05). There were significant correlations between graft-to-recipient weight ratio (GRWR), donor gender, original_shape_Maximum2DDiameterColumn, recipient’s body surface area (BSAr) and LRR. The regression equation predicting LRR was following: LRR(%) = 104.50-24.77×GRWR(%) − 0.134×original_shape_Maximum2DDiameterColumn + 38.16×BSAr(m²) + 10.52(if the donor is male). Conclusions Preoperative CT texture analysis combined with clinical information can non-invasively predict early graft regeneration after pediatric left lateral lobe LDLT. GRWR, donor gender, original_shape_Maximum2DDiameterColumn, and BSAr are independent influencing factors of LRR.