Using a small-for-size graft might attribute to the future use of left-lobe living graft in adult to adult living donor liver transplantation
Li, H-Yu.; Wei, Y-Gang.; Yan, L-Nan.; Wen, T-Fu.; Zhao, J-Chun.; Xu, M-Qing.; Wang, W-Tao.; Yang, J-Yin.
Hepato-Gastroenterology 59(119): 2050-2053
2012
ISSN/ISBN: 0172-6390 PMID: 22640916 Document Number: 657847
Adult to adult living donor liver transplantation (AALDLT) is performed worldwide. The aim of this study was to evaluate using a graft with graft to body weight ratio (GBWR) less than 0.8 in right-lobe AALDLT recipients. Clinical data of 127 patients who had right-lobe AALDLT from January 2002 to November 2009 were retrospectively analyzed. Patients were divided into two groups according to GBWR (group A: 0.6 ≤ GBWR < 0.8, group B: GBWR ≥ 0.8). Preoperative characteristics, postoperative complications graded by the Clavien score and patient survival time were recorded and analyzed. GBWR between the two groups were significantly different (0.67 ± 0.05 vs. 0.97 ± 0.17, p = 0.000). There was no significant difference in preoperative demographic data as well as postoperative liver function data. Complication rate, median ICU stay and small-for-size syndrome incidence were similar in both groups. In univariate analysis, only MELD emerged as independent risk factor for small-for-size syndrome (p = 0.045). Patient survival was similar in both groups at 1, 3 and 5 years as well. Using a GBWR of less than 0.8 is safe in selected recipients. To some extent, this result may attribute to the wide use of left-lobe living graft in AALDLT in future.