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Outcomes of adult‐to‐adult living donor liver transplantation in 321 recipients
Author(s) -
Uchiyama Hideaki,
Shirabe Ken,
Kimura Koichi,
Yoshizumi Tomoharu,
Ikegami Toru,
Harimoto Norifumi,
Maehara Yoshihiko
Publication year - 2016
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.24378
Subject(s) - medicine , liver transplantation , surgery , living donor liver transplantation , retrospective cohort study , complication , transplantation
We conducted a retrospective investigation in order to clarify whether selecting the type of liver graft had an impact on outcomes of adult‐to‐adult living donor liver transplantation (AALDLT). Data from the medical records of the donors and the recipients of 321 consecutive cases of AALDLT performed between April 2004 and March 2014 were retrospectively analyzed. Our general criteria for selecting the type of liver graft was that a left graft was preferentially selected when the estimated volume of the left graft was ≥35% of the standard liver volume of the recipient, and that a right graft was selected only when the estimated remnant liver volume of the donor was ≥35% of the total liver volume. In this series, 177 left grafts, 136 right grafts, and 8 posterior grafts were used. The left grafts tended to have 2 or more arteries, whereas the right grafts tended to have 2 or more bile duct orifices. The graft survival curves and the incidences of severe complications were comparable between the AALDLT using right grafts and the AALDLT using left grafts. The preoperative estimation of graft size hardly enabled us to predict severe posttransplant complication. Moreover, small‐for‐size graft syndrome occurred regardless of the estimated graft volumes. Instead, donor age was a significant risk factor for small‐for‐size graft syndrome. In conclusion, left grafts should be more aggressively used for the sake of donors' safety. The use of hepatic grafts from older donors should be avoided if possible in order to circumvent troublesome posttransplant complications. Liver Transpl 22:305‐315, 2016 . © 2015 AASLD.