Durability of small-for-size living donor allografts.

Abstract

Our aim was to study the long-term outcomes of living donor liver transplantation using small-for-size (SFS) grafts. From July 2002 to July 2009, 233 patients received a right liver graft with a middle hepatic vein from a living donor in our center. Recipients were stratified according to the graft weight to recipient standard liver volume (GW/SLV) ratio into 4 groups: >50% (n = 89), >40% to 50% (n = 85), >35% to 40% (n = 38), and ≤ 35% (n = 21). They were compared in terms of graft survivals, biliary stricture rates, renal function in terms of estimated glomerular filtration rate (eGFR), platelet counts, and graft function in terms of serum bilirubin and international normalized ratio (INR). The 5-year graft survivals for patients with GW/SLV of >50%, >40% to 50%, >35% to 40% and ≤ 35% were 88.8%, 88.2%, 81.5%, and 81.0%, respectively. Transplantation for hepatocellular carcinoma affected graft survivals (P = 0.02), but graft size did not (P = 0.66). There were no differences in frequency of biliary stricture (21.3% versus 17.1% versus 21.1% versus 28.6%; P = 0.75). At each year after transplant, their platelet counts (P = 0.12-0.65), eGFR (P = 0.49-0.91), bilirubin (P = 0.14-0.51), and INR (P = 0.20-0.98) remained comparable. SFS grafts with GW/SLV ≤ 35% and >35% to 40% had comparable long-term outcomes with larger liver grafts. Graft size did not affect long-term graft survivals.

• Authors: Kin Pan Au, See Ching Chan, Kenneth Siu Ho Chok, Albert Chi Yan Chan, Tiffany Cho Lam Wong, William Wei Sharr, Chung Mau Lo
• Journal: Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society (Liver Transpl) Vol. 21 Issue 11 Pg. 1374-82 (Nov 2015) ISSN: 1527-6473 [Electronic] United States
• PMID: 26123155 (Publication Type: Journal Article)
• Copyright: © 2015 American Association for the Study of Liver Diseases.

Topics

• Adult
• Allografts
• Female
• Follow-Up Studies
• Graft Survival
• Humans
• Liver (anatomy & histology, surgery)
• Liver Failure (surgery)
• Liver Transplantation (methods)
• Living Donors (supply & distribution)
• Male
• Middle Aged
• Organ Size
• Retrospective Studies
• Time Factors
• Tissue and Organ Harvesting (standards)
• Tissue and Organ Procurement (standards)
• Transplant Recipients
• Treatment Outcome