Using a Small-For-Size Graft Might Attribute to the Future Use of Left-Lobe Living Graft in Adult to Adult Living Donor Liver Transplantation

Background/Aims: Adult to adult living donor liver transplantation (AALDLT) is performed worldwide. The aim of this study was to evaluate using a graft with graft to body weight ratio (GBWR) less than 0.8 in right-lobe AALDLT recipients. Methodology: Clinical data of 127 patients who had right-lobe AALDLT from January 2002 to November 2009 were retrospectively analyzed. Patients were divided into two groups according to GBWR (group A: 0.6 <= GBWR <0.8, group B: GBWR >= 0.8). Preoperative characteristics, postoperative complications graded by the Clavien score and patient survival time were recorded and analyzed. Results: GBWR between the two groups were significantly different (0.67 +/- 0.05 vs. 0.97 +/- 0.17, p=0.000). There was no significant difference in preoperative demographic data as well as postoperative liver function data. Complication rate, median ICU stay and smallfor-size syndrome incidence were similar in both groups. In univariate analysis, only MELD emerged as independent risk factor for small-for-size syndrome (p=0.045). Patient survival was similar in both groups at 1,3 and 5 years as well. Conclusions: Using a GBWR of less than 0.8 is safe in selected recipients. To some extent, this result may attribute to the wide use of left-lobe living graft in AALDLT in future.