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.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Department of Liver and Vascular Surgery, Center of Liver Transplantation, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Hong-Yu
HY
Li
Yong-Gang
YG
Wei
Lv-Nan
LN
Yan
Tian-Fu
TF
Wen
Ji-Chun
JC
Zhao
Ming-Qing
MQ
Xu
Wen-Tao
WT
Wang
Jia-Yin
JY
Yang
D000328:Adult; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D046148:Donor Selection; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome; D055815:Young Adult
D015415:Biomarkers