Faculty Collaboration Database

The right small-for-size graft results in better outcomes than the left small-for-size graft in adult-to-adult living donor liver transplantation. World J Surg 2008 Aug;32(8):1722-30

Date

06/17/2008

Pubmed ID

18553047

DOI

10.1007/s00268-008-9641-6

Scopus ID

2-s2.0-48549107500 (requires institutional sign-in at Scopus site)   27 Citations

Abstract

BACKGROUND: The recent outcome of adult-to-adult living donor liver transplantation (ALDLT) using small-for-size grafts (SFSGs; GRWR <0.8%) has been excellent after right grafts were exclusively used in large-volume ALDLT centers.

METHODS: We compared the outcome of ALDLTs using 11 right SFSGs (group R) with that using 18 left SFSGs (group L) of our center. The dysfunction of graft was defined dysfunction as hyperbilirubinemia (>5 mg/dl), prolonged prothrombin time (>2 INR), or uncontrolled ascites (>1,000 ml/day) on 3 consecutive days in posttransplant 7 days, and the dysfunction score (DS; the sum of points given per each sign) of the graft was used to describe the SFSG dysfunction severity.

RESULTS: The pretransplant recipient status was similar between the groups, but the 1-year mortality rate was 0% in group R and 33.3% (n = 6) in group L (p = 0.038). The ICU stay was longer in group L (20 days) than in group R (11 days; p = 0.004). Hyperbilirubinemia in group R vs. L was noted in 54.5% vs. 50%, prolonged prothrombin time in 18.2% vs. 50%, and uncontrolled ascites in 54.5% vs. 100%. The DS was lower in group R than in group L (1.3 vs. 2; p = 0.007). The DS was zero in four right liver recipients. On multivariate analysis, the only factor affecting DS was the graft side.

CONCLUSION: The clinical signs of SFSG dysfunction were less arduous and there was no 1-year mortality in cases in group R. Therefore, the right SFSG may be used for ALDLT in the future base on the transplant center's experience.

Author List

Yi NJ, Suh KS, Cho YB, Lee HW, Cho EH, Cho JY, Shin WY, Kim J, Lee KU

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Female
Graft Survival
Humans
Liver Function Tests
Liver Transplantation
Living Donors
Male
Middle Aged
Organ Size
Postoperative Complications
Risk Factors
Statistics, Nonparametric
Tissue and Organ Harvesting
Treatment Outcome