Standard liver weight model in adult deceased donors with fatty liver: A prospective cohort study

Table 1 Characteristics of the deceased donors

Characteristic	Total, n = 212
Sex, male, n (%)	167 (78.8)
Age, median (range), yr	49 (18–68)
BH, median (range), cm	168 (150–185)
BW, median (range), kg	65 (45–90)
BMI, median (range), kg/m2	23.35 (15.57–30.48)
BSA, median (range), m2	1.73 (1.37–2.10)
TLW, median (range), g	1400 (830–2100)
Cause of death, n (%)
Trauma	106 (50.0)
Cerebrovascular	97 (45.8)
Other	9 (4.2)
Degree of fatty change, median (range)	0 (0–40%)
0, n (%)	151 (71.2)
> 0, < 5%, n (%)	32 (15.1)
5%–33%, n (%)	22 (10.4)
> 33%, n (%)	7 (3.3)
Ballooning of hepatocytes
None	24 (11.1)
Ballooned hepatocyte with normal size	116 (54.9)
Enlarged ballooned hepatocyte	72 (34.0)
Lobular inflammation
None	66 (30.9)
< 2 foci per lobule	131 (61.7)
> 2 foci per lobule	15 (7.4)
Necrosis
None	200 (94.4)
Focal or unicellular necrosis	8 (3.7)
More extensive necrosis and above	4 (1.9)
Stage of fibrosis1
0	72 (33.8)
1	88 (41.6)
2	47 (22.1)
3	4 (1.9)
4	1 (0.6)

¹According to the modified Scheuer system[22]. BH: Body height; BW: Body weight; BMI: Body mass index; BSA: Body surface area; TLW: Total liver weight.

Table 2 Factors related to the total liver weight of the deceased donors

Factor	R2	P value	95%CI
Sex	0.226	< 0.001	220.89–369.68
BH	0.241	< 0.001	13.92–22.78
BW	0.441	< 0.001	15.25–20.77
BSA	0.454	< 0.001	1024.56–1383.79
BMI	0.224	< 0.001	32.28–54.18
Degree of fatty change (< 5%, 5%–20%, > 20%)	0.130	< 0.001	116.89–244.17
Hepatic steatosis1	0.125	< 0.001	149.67–318.33

¹Diagnosed by ultrasound. BH: Body height; BW: Body weight; BSA: Body surface area; BMI: Body mass index.

Table 3 Results for livers with more than 5% fatty change diagnosed by ultrasound and pathological biopsy in the deceased donors

Ultrasound	Pathological biopsy		Total
	+	-
+	25	13	38
-	4	170	174
Total	29	183	212

According to the table above, livers with a fatty change of more than 5% were diagnosed by ultrasound, and the sensitivity and specificity were 86.2% and 92.9%, respectively. The chi-square test showed that the kappa value was 0.70, P < 0.001.

Table 4 Results of multiple linear regression analysis performed to predict the total liver weight using each of the body anthropometric measures divided into groups of the traditional method and two new methods, which introduce the parameter of fatty liver diagnosed by ultrasound and pathological biopsy

Groups	Formulas	Adjusted R2	RMSE
Traditional method
BH	- 809.4 + 167.3 x Sex + 12.6 x BH	0.29	212.0
BW	322.1 + 147.0 x Sex + 15.2 x BW	0.49	181.1
BSA	- 466.9 + 99.0 x Sex + 1051.0 x BSA	0.48	182.8
BMI	329.2 + 264.5 x Sex + 37.8 x BMI	0.39	196.5
Ultrasound method
BH	- 1011.9 + 149.7 x Sex + 13.6 x BH + 240.7 x FLUS	0.43	191.1
BW	392.7 + 158.3 x Sex + 13.5 x BW + 158.6 x FLUS	0.54	171.4
BSA	- 348.6 + 110.7 x Sex + 958.0 x BSA + 179.8 x FLUS	0.55	169.9
BMI	453.7 + 264.5 x Sex + 31.2 x BMI + 162.9 x FLUS	0.45	187.5
Pathological biopsy method (< 5%, 5%–20%, > 20%)
BH	- 803.7 + 178.5 x sex + 12.3 x BH + FLPB (0 = 0, 1 = 163.5, 2 = 393.0)	0.43	190.0
BW	414.5 + 172.6 x sex + 13.1 x BW + FLPB (0 = 0, 1 = 79.8, 2 = 280.7)	0.54	170.8
BSA	- 288.8 + 129.5 x sex + 919.6 x BSA + FLPB (0 = 0, 1 = 93.9, 2 = 304.5)	0.55	170.0
BMI	478.1 + 276.5 x Sex + 30.0 x BMI + FLPB (0 = 0, 1 = 105.3, 2 = 299.1)	0.46	185.4

Sex and FL_US are binary variables; FL_PB is a dummy variable. Sex: 0 = Female, 1 = Male; FL_US: 0 = No, 1 = Yes; FL_PB: 0 < 5%, 1 = 5%–20%, 2 > 20%. BH: Body height; BW: Body weight; BSA: Body surface area; BMI: Body mass index; FL_US: Fatty liver diagnosed by ultrasound; FL_PB: Fatty liver diagnosed by pathological biopsy; RMSE: Root mean standard error.

Table 5 Differences between the estimated and actual liver weights calculated using previous formulas in our deceased donor cohort.

Ref.	Formula	Difference1 (g)	RMSE	ICC	P value2
Autopsy
DeLand et al[29]	1020 × BSA - 220	135.5 (-366–632)	221.2	0.52	< 0.01
Heinemann et al[26]	1072.8 × BSA - 345.7	95 (-421–556)	202.5	0.56	< 0.01
Yu et al[25]	21.585 × BW0.732 × BH0.225	34.5 (-490–576)	187.5	0.61	0.102
Choukèr et al[30]	[16–50 yr] 452 + 16.34 x BW + 11.85 × age - 166 × sex (1 = female, 0 = male) 51–70 yr] 1390 + 15.94 × BW - 12.86 × age	435 (-301–1000)	484.0	0.24	< 0.01
General population/living donor
Urata[6]	706.2 × BSA + 2.4	-185 (-713–337)	278.1	0.32	< 0.01
Lin et al[28]	13 × BH + 12 × BW - 1530	11.5 (-546–445)	188.0	0.63	0.472
Vauthey et al[31]3	1267.28 × BSA - 794.41	-15 (-544–421)	188.1	0.64	< 0.01
Hashimoto et al[32]	961.3 × BSA - 404.8	-161 (-668–317)	253.4	0.42	< 0.01
Chan et al[33]	218 + BW × 12.3 + sex × 51 (0 = female, 1 = male)	-356.5 (-859–175)	411.1	0.21	< 0.01
Yuan et al[34]	949.7 × BSA - 247.4–48.3 x age factor (1, < 40; 2, 41–60; 3, > 60)	-106 (-646–359)	228.0	0.48	< 0.01
Fu-Gui et al[23]	11.508 × BW + 334.024	-319 (-845–241)	393.6	0.19	< 0.01
Poovathumkadavil et al[35]	12.26 × BW + 555.65	-57 (-572–510)	207.5	0.47	< 0.01
Um et al[36]	893.485 x BSA − 439.169	-312.5 (-816–173)	372.8	0.24	< 0.01
Cadaveric population
Yoshizumi et al[18]3	772 × BSA	-79 (-602–416)	214.6	0.45	< 0.01
Current	- 348.6 + 110.7 x Sex (0 = Female, 1 = Male) + 958.0 x BSA + 179.8 x FLUS (0 = No, 1 = Yes)	1.5 (-477.0–450.0)	168.3	0.71	1

¹Difference between estimated and actual liver weight using previous formulas.

²Paired-samples t test.

³Mosteller’s formula[37] was adopted for BSA, and the remaining formulas used the Dubois formula[27].

BH: Body height; BW: Body weight; BSA: Body surface area; BMI: Body mass index; FL_US: Fatty liver diagnosed by ultrasound; ICC: Interclass correlation coefficient; RMSE: Root mean standard error.