Using small size grafts in live donor liver transplantation: is size important?

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Pamukkale University

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Purpose: In living donor liver transplantation, it is preferred that the ratio of the weight of the graft to the weight of the recipient (GRWR) be higher than 0.8%. We aimed to compare recipients with a GRWR greater than 0.8% and those with a small GRWR regarding post-transplant complications and outcomes. Materials and methods: Data of the patients who had undergone living donor liver transplant surgery in İstinye University Hospital Liver Transplant Unit between January 2017 and July 2022 were reviewed. The study group patients were classified as GRWR<0.8% (Group 1), GRWR 0.8-1% (Group 2), and GRWR>1% (Group 3) and compared regarding clinical data, complications, and mortality rates. Results: Liver transplant recipients from 220 living donors were included. The mean recipient age was 53.6 (18-79). The comparative analysis between Group 1 (n=29), Group 2 (n=70), and Group 3 (n=121) revealed significant differences concerning the rates of bile leak and the length of hospital stay (p=0.033, p<0.05). Bile leak rates were 7.4% in Group 1, 6% in Group 2, and 0.8% in Group 3. The bile leakage rate was significantly lower in Group 3 than in Groups 1 and 2 (p=0.041, p<0.05). The medians of hospitalization periods were 18 (7-40) days, 15 (5-46) days, and 16 (1-130) days in groups 1, 2, and 3. In addition, the median length of stay was higher in Group 1 than in groups 2 and 3 (p=0.033). In terms of other parameters, the three groups gave similar results. Conclusion: Although a GRWR value of lower than 0.8 seems as a factor causing prolonged hospital stay, and a GRWR value of higher than 1 seems to lower the risk of biliary complications after a live donor liver transplantation, these changes are not associated with the changes in total complication and acute rejection rates and patient survival. © 2023, Pamukkale University. All rights reserved.


Anahtar Kelimeler

Graft Recipient Weight Ratio, Live Donor, Liver Transplantation


Pamukkale Medical Journal

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