Open AccessSection 7. A New Therapeutic Strategy on Portal Flow Modulation That Increases Donor Safety With Good Recipient Outcomes
Author(s) -
Toshimi Kaido,
Kohei Ogawa,
Yasuhiro Fujimoto,
Takashi Ito,
Koji Tomiyama,
Akira Mori,
Yasuhiro Ogura,
Shinji Üemoto
Publication year - 2014
Publication title -
transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.45
H-Index - 204
eISSN - 1534-6080
pISSN - 0041-1337
DOI - 10.1097/01.tp.0000446271.28557.e8
Subject(s) - medicine , living donor liver transplantation , high pressure , surgery , transplantation , liver transplantation , engineering , engineering physics
The goal of this study was to examine whether the lower limit of the graft-to-recipient weight ratio (GRWR) can be safely reduced to make better use of the left lobe graft in adult-to-adult living donor liver transplantation in combination with portal pressure control. Beginning December 2007, the acceptable limit for GRWR was lowered to ≥0.7% and by April 2009, it was further lowered to ≥0.6%. A portal pressure control program targeting a final portal pressure <15 mm Hg was also introduced. The donor complication rate decreased from 13.8% to 9.3%. The overall survival of recipients with GRWR <0.8% did not differ from recipients with a GRWR ≥0.8%. In conclusion, the lower limit of the GRWR can be safely reduced to 0.6% using a left lobe graft in adult-to-adult living donor liver transplantation in combination with portal pressure control.