Increasing donor body weight to prevent small-for-size syndrome in living donor liver transplantation.
BACKGROUND
This study was designed to evaluate the possibility of avoiding small-for-size syndrome (SFSS) in living donor liver transplantation (LDLT) by increasing the donor's body weight (BW) before liver donation.


METHODS
Nineteen participants, including 15 volunteers and 4 liver donors, were enrolled in this study to increase their BW by 1.5-5 kg within 3 months by eating a high-protein and high-carbohydrate diet according to a flexible formula to increase calorie intake.


RESULTS
Fifteen participants, including 12 volunteers and 3 live liver donors, successfully increased their BW by 1.5-5 kg within 3 months (failure rate, 21%). The actual liver weight (LW) gain was more than the expected LW gain using the formula for calculating standard liver volume (2.77- to 8.94-fold; median, 4.49-fold; mean, 4.45-fold, P < 0.005) and using the ratio of liver weight to body weight (1.36- to 4.49-fold; median, 2.01-fold; mean, 2.06-fold, P < 0.005). The enlargement of the livers was symmetrical without significant fatty change. The graft-versus-recipient weight ratio increased 0.17%, 0.07%, and 0.08%, respectively, for the three live liver donors and successful LDLTs were performed.


CONCLUSIONS
By having liver donors eat a high-protein, high-carbohydrate diet to increase their BW in a short period of time, the actual LW may increase more than the expected LW gain without fatty change. This method of increasing LW may be used in selected cases of LDLT to avoid SFSS.
Department of Surgery, Taipei Veterans General Hospital, School of Medicine, National Yang-Ming University, #201, Section 2, Shih-Pai Road, Taipei, 112, Taiwan. csliu@vghtpe.gov.tw
Chinsu
C
Liu
Rheun-Chuan
RC
Lee
Che-Chuan
CC
Loong
Cheng-Yuan
CY
Hsia
Yi-Chen
YC
Yeh
See-Ying
SY
Chiou
D000328:Adult; D001835:Body Weight; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D015430:Weight Gain