An anatomical analysis of liver volume and quality by ethnicity in a New Zealand population

BackgroundPost-hepatectomy liver failure is a major cause of mortality, where future liver remnant (FLR) is the key controllable factor. Recommended minimum FLR is influenced by quality of liver parenchyma. Historical research has often failed to include M & amacr;ori and Pacific Island (PI) populations despite worse health outcomes. Liver analysis by ethnicity is one such example of this. The aims were to determine digital FLR for various anatomical hepatectomies, investigate any correlations between computed tomography (CT) hepatic textural analysis and body mass index (BMI); and assess the variance of these relationships for different ethnicities.MethodOne hundred and fifty-one patients who underwent abdominal CT scans at Burwood Hospital, Christchurch were retrospectively analysed. M & amacr;ori and PI patients were selectively recruited to represent New Zealand's diversity. Liver volumetry, segmental ratio, and intra-hepatic fat deposits (IHFD) per ethnicity were examined.ResultsMedian age of the cohort was 66 (19-95) and 75 (50%) were males. 68%, 23% and 9% patients identified as being European, M & amacr;ori/PI and Asian, respectively. No statistically significant difference in volume or segment/total volume ratio were noted across different ethnicities. Obese patients had higher IHFD compared with overweight and normal BMI groups. When stratified across ethnic groups, higher IHFD were observed in Asian compared with M & amacr;ori/PI populations, despite lower BMI.ConclusionNo significant variances in liver volumetry were found across different ethnic groups in New Zealand. However association between BMI and IHFD varied across different ethnic cohorts. Consequently, knowledge of liver volumetry is not enough; patient liver quality and ethnicity should considered for hepatic-surgery planning. Post-hepatectomy liver failure is associated with inadequate future liver remnant, which is influenced by liver quality. No significant variances in liver volumetry were found across different ethnic groups in New Zealand. However, the strength of correlation between Body Mass Index and Intra-hepatic fat deposits varied amongst the ethnic cohorts. Consequently, knowledge of liver volumetry is not enough and liver quality and patient ethnicity should be taken into consideration when planning management for hepatic neoplasms.image