Massive ascites after living donor liver transplantation with a right lobe graft larger than 0.8% of the recipient's body weight.
BACKGROUND
There are only limited data on post-transplant ascites unrelated to small-sized grafts in living donor liver transplantation (LDLT).


METHODS
The subjects were 59 adult patients who had received right lobe LDLT with a graft weight-to-recipient weight ratio (GRWR)>0.8%. Patients were divided into either Group 1 (n=14, massive ascites, defined as the production of ascitic fluid>1000 mL/d that lasted longer than 14 d after LDLT) or Group 2 (n=45, no development of massive ascites). Patients were followed for a median period of 3.0 yr (range, 0.5-7.5 yr).


RESULTS
Group 1 had both higher Model for End-Stage Liver Disease score and Child-Pugh score than Group 2. Portal venous flow volume just after reperfusion was significantly greater in Group 1 than Group 2 (307.8±268.8 vs. 176.2±75.0 mL/min/100 g graft weight, respectively; p<0.05). Post-transplant infectious complications including ascites infection developed more frequently within the first post-transplant month in Group 1. Massive ascites was significantly associated with early graft loss (p<0.05).


CONCLUSIONS
Post-transplant massive ascites associated with portal over-perfusion into the graft liver can develop in patients with a GRWR over 0.8%. Recipients with post-transplant massive ascites require careful management to prevent infection.
Shirouzu
Yasumasa
Y
Department of Transplantation and Pediatric Surgery, Postgraduate School of Medical Science, Kumamoto University, Honjo, Kumamoto, Japan. shirouzu@fc.kuh.kumamoto-u.ac.jp
Ohya
Yuki
Y
Suda
Hiroko
H
Asonuma
Katsuhiro
K
Inomata
Yukihiro
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D001201:Ascites / Q000209:etiology* / Q000473:pathology; D001835:Body Weight; D005260:Female; D006085:Graft Survival; D006801:Humans; D008099:Liver / Q000033:anatomy & histology / Q000601:surgery*; D017093:Liver Failure / Q000628:therapy*; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult