Alleviating the Burden of Small‐for‐Size Graft in Right Liver Living Donor Liver Transplantation Through Accumulation of Experience

The issue of small‐for‐size graft (SFSG) containing the middle hepatic vein in right liver living donor liver transplantation from 1996 to 2008 (n = 320) was studied. Characteristics of donors, grafts and recipients were comparable between Era I (first 50 cases) and Era II (next 270 cases) except th...

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Bibliographic Details
Published in:American journal of transplantation 2010-04, Vol.10 (4), p.859-867
Main Authors: Chan, S. C., Lo, C. M., Ng, K. K. C., Fan, S. T.
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Blood & organ donations
Confidence intervals
Epidemiology
General aspects
Hepatic vein
Hospital Mortality
Humans
Liver
Liver diseases
Liver Transplantation
Liver transplants
Liver, biliary tract, pancreas, portal circulation, spleen
living donor transplantation
Living Donors
Medical sciences
Mortality
Public health. Hygiene
Public health. Hygiene-occupational medicine
right liver graft
Skin & tissue grafts
small‐for size graft
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
transplant outcomes
transplant research
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Summary:The issue of small‐for‐size graft (SFSG) containing the middle hepatic vein in right liver living donor liver transplantation from 1996 to 2008 (n = 320) was studied. Characteristics of donors, grafts and recipients were comparable between Era I (first 50 cases) and Era II (next 270 cases) except that the median model for end‐stage liver disease (MELD) score was higher in Era I (29 vs. 24; p = 0.024). The median graft to standard liver volume ratio (G/SLV) in Era I was 49.0% (range, 32.8–86.2%), versus 49.3% (range, 28.4–89.4%) in Era II (p = 0.498). Hospital mortality rate, the study endpoint, dropped from 16.0% (8/50) in Era I to 2.2% (6/270) in Era II (p = 0.000). Univariate analysis showed that MELD score (p = 0.002), pretransplant hepatorenal syndrome (p = 0.000) and Era I (p = 0.000) were significant in hospital mortality. Logistic regression analysis showed that only Era I (relative risk 9.758; 95% confidence interval, 2.885–33.002; p = 0.000) was significant. In Era I, G/SLV
ISSN:1600-6135
1600-6143
DOI:10.1111/j.1600-6143.2010.03017.x