Which is better to use "body weight" or "standard liver weight", for predicting small-for-size graft syndrome after living donor liver transplantation?

被引:11
作者
Toshima, Takeo [1 ]
Yoshizumi, Tomoharu [1 ]
Shimagaki, Tomonari [1 ]
Wang, Huanlin [1 ]
Kurihara, Takeshi [1 ]
Nagao, Yoshihiro [1 ]
Itoh, Shinji [1 ]
Harada, Noboru [1 ]
Mori, Masaki [1 ]
机构
[1] Kyushu Univ, Grad Sch Med Sci, Dept Surg & Sci, Fukuoka, Japan
来源
ANNALS OF GASTROENTEROLOGICAL SURGERY | 2021年 / 5卷 / 03期
基金
日本学术振兴会;
关键词
graft weight per standard liver weight; graft‐ to‐ recipient weight ratio; liver transplantation; living donor liver transplantation; small‐ for‐ size graft syndrome; SINGLE-CENTER EXPERIENCE; IMPACT; RATIO; CONGESTION; MODULATION; OBESITY; VOLUME; AGE;
D O I
10.1002/ags3.12412
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Aim Little evidence about whether to apply graft-to-recipient body weight ratio (GRWR) or graft weight to standard liver weight (GW/SLW) for graft selection has been published. The aim of the present study was to clarify the importance of the correct use of GRWR and GW/SLW for selecting graft according to the recipients' physique in living donor liver transplantation (LDLT). Methods Data were collected for 694 recipients who underwent LDLT between 1997 and 2020. Results One of the marginal grafts meeting GW/SLW >= 35% but GRWR < 0.7% has been used in more recipients with men and higher body mass index (BMI), and the other meeting GRWR >= 0.7% but GW/SLW 30 kg/m(2), the recipients with GRWR < 0.7% had a significantly higher incidence of small-for-size graft syndrome (SFSS) compared to those with GRWR >= 0.7% (P = 0.008, 46.2% vs 5.9%), and using the cutoff of GW/SLW < 35% could not differentiate. In contrast, in the cohort of BMI <= 30 kg/m(2), the recipients with GW/SLW < 35% also had a significantly higher incidence of SFSS (P = 0.013, 16.9% vs 9.4%). Multivariate analysis showed that GRWR < 0.7% [odds ratio (OR) 14.145, P = 0.048] was the independent risk factor for SFSS in obese recipients, and GW/SLW < 35% [OR 2.685, P = 0.002] was the independent risk factor in non-obese recipients. Conclusion Proper use of the formulas for calculating GRWR and GW/SLW in choosing graft according to recipient BMI is important, not only to meet metabolic demand for avoiding SFSS but also to ameliorate donor shortages.
引用
收藏
页码:363 / 372
页数:10
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