title: Liver lobe graft side and outcomes in living-donor liver transplant with small-for-size grafts.
abstract: OBJECTIVE
  Living-donor liver transplant with small-for-size grafts (graft-to-recipient weight ratio < 0.8) may provide satisfactory results. We compared outcomes between right and left donor lobe in living-donor liver transplant.
  
  
  METHODS
  Patients who had living-donor liver transplant from 2006 to 2008 with graft-to-recipient weight ratio < 0.8 (graft: right lobe, 24 patients; left lobe, 26 patients) were reviewed retrospectively.
  
  
  RESULTS
  There were no significant differences in demographic and preoperative clinical data between patients who received a right or left lobe liver graft. Duration of surgery was longer, cold ischemia time was shorter, and mean baseline portal vein flow was greater in transplants performed with left than right donor lobes. Portal vein flow modulation with splenectomy was performed when portal flow was > 250 mL/min/100 g graft. Small-for-size syndrome was observed in 6 recipients (14%), but no patient who developed small-for-size syndrome developed liver failure or required revision transplant. The frequency of small-for-size syndrome was significantly greater in patients who had left lobe (4 patients [15%]) than right lobe transplant (2 patients [8%]; P ≤ .05). Graft dysfunction-free survival was significantly greater with right than left lobe grafts. In multivariate analysis, graft side was the only significant risk factor for small-for-size syndrome.
  
  
  CONCLUSIONS
  In patients having living-donor liver transplant with small-for-size grafts, outcome was better with right than left lobe grafts.
authors.affiliation: From the Liver Transplantation Program and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Karan D
authors.initials: KD
authors.lastname: Julka
authors.forename: Chao-Long
authors.initials: CL
authors.lastname: Chen
authors.forename: Bhavin
authors.initials: B
authors.lastname: Vasavada
mesh_terms: D001783:Blood Flow Velocity; D016009:Chi-Square Distribution; D050377:Cold Ischemia; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008099:Liver / Q000473:pathology / Q000601:surgery*; D008102:Liver Circulation; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D061646:Operative Time; D009929:Organ Size; D011169:Portal Vein / Q000503:physiopathology / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D013156:Splenectomy; D013997:Time Factors; D016896:Treatment Outcome