• Maciej Miarka, Krzysztof Gibiński, Marcin Kotulski, Krzysztof Zając, Magdalena Chmielewska, Bogna Wardeńska, Ryszard Pacho, and Joanna Raszeja-Wyszomirska.
• Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
• Pol. Arch. Med. Wewn. 2020 Aug 27; 130 (7-8): 622-628.

IntroductionIn patients with cirrhosis, only a 75% liver volume (LV) is expected compared with age‑matched healthy individuals. Changes in LV might be an indicator of therapeutic effectiveness or disease progression.ObjectivesTo establish whether LV is a prognostic factor in chronic liver disease irrespective of etiology and LV impacts the outcomes of liver transplant (LT).Patients And MethodsIn total, 135 consecutive LT recipients were prospectively included in this study: 38 women and 97 men. The median (minimum-maximum) age was 51 (21-70) years; body mass index (BMI), 27.3 (17.3-39.2) kg/m2; Child-Pugh class (CPC), C; Model of End‑Stage Liver Disease (MELD), 16 (7-47) points; and the third lumbar vertebra skeletal muscle index (L3SMI), 47.7 (19.7-73.4) cm2/m2. Liver volume and L3SMI were calculated based on computed tomography scans at listing for LT. The receiver operating characteristic (ROC) curve was analyzed to determine the accuracy of LV in mortality prediction after LT.ResultsLiver volume differed significantly among patients in terms of chronic liver disease etiology, with the lowest values noted in those with hepatitis C virus infection. Liver volume was neither a prognostic factor of disease progression and need for LT with respect to the CPC and MELD scores nor correlated with BMI and L3SMI (P >0.05). The area under the ROC curve of LV in mortality prediction was 0.573 (95% CI, 0.403-0.743). Liver volume smaller than the median tended to be positively associated with the risk of prolonged intensive care unit stay and death (P = 0.057 and P = 0.058, respectively).ConclusionsLow liver volume did not seem be a point of no return in LT candidates.

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