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Body surface area index predicts outcome in orthotopic liver transplantation
Author(s) -
Fukazawa Kyota,
Nishida Seigo,
Volsky Alex,
Tzakis Andreas G.,
Pretto Ernesto A.
Publication year - 2011
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1007/s00534-010-0334-9
Subject(s) - medicine , body surface area , cadaveric spasm , liver transplantation , orthotopic liver transplantation , surgery , transplantation , cardiology , incidence (geometry) , thrombosis , physics , optics
Background/Purpose In living donor liver transplantation (LDLT), matching of liver volume between donor and recipient is critical to the success of the procedure; mismatch can result in ‘small‐ or large‐for‐size syndrome’. In orthotopic liver transplantation (OLT), matching criteria are less stringent and non‐uniform. We sought to determine whether a new parameter, the ratio of donor to recipient body surface area (BSAi), is predictive of size mismatch and/or post‐transplant morbidity or mortality. Methods We reviewed data on 1228 OLT recipients and stratified this data according to three categories: small‐for‐size (BSAi <0.6), control (BSAi = 0.6–1.4), and large‐for‐size (BSAi >1.4) donors. Results We found that: (1) matching of grafts at the upper and lower extremes of BSAi had significantly reduced graft survival; (2) matches with lower BSAi sustained a less severe form of intraoperative post‐reperfusion syndrome, and the incidence of hepatic artery thrombosis was high postoperatively in these grafts; (3) BSAi and donor age correlated well with the severity of intraoperative post‐reperfusion hypotension; and (4) small‐for‐size (BSAi <0.6) and large‐for‐size (BSAi >1.4) grafts, as well as preoperative total bilirubin, were significant risk factors for decreased graft survival. Conclusion We conclude that the BSAi can predict clinically significant size mismatch and adverse outcomes in cadaveric whole OLT.