Premium
Impact of graft‐to‐recipient weight ratio on small‐for‐size syndrome following living donor liver transplantation
Author(s) -
Bell Richard,
Pandanaboyana Sanjay,
Upasani Vivek,
Prasad Raj
Publication year - 2018
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.14245
Subject(s) - medicine , perioperative , odds ratio , hazard ratio , living donor liver transplantation , liver transplantation , surgery , meta analysis , incidence (geometry) , transplantation , confidence interval , physics , optics
Background This meta‐analysis aimed to compare living donor liver transplantation ( LDLT ) grafts with a graft‐to‐recipient weight ratio ( GRWR ) of <0.8 to grafts with a GRWR ≥0.8 with regards to small‐for‐size syndrome ( SFSS ) and short and longer term outcomes. Methods An electronic search was performed of the MEDLINE , EMBASE and PubMed databases until December 2016 using both subject headings ( MeSH ) and free text. Pooled odds ratios and hazard ratios were calculated using fixed‐ and random‐effects models for meta‐analysis. Results Eight studies including 1833 patients met the inclusion criteria. The rate of SFSS was 10% in the <0.8 group and 5% in the ≥0.8 group (odds ratio: 1.69 (1.09, 2.61) ( P = 0.020)). No significant difference was noted between the two groups with regards to graft survival up to 5 years (hazard ratio: 1.31 (0.88, 1.94) ( P = 0.190)). Similarly, no significant difference was noted in overall complications ( P = 0.06), biliary ( P = 0.290) or vascular complications ( P = 0.190), perioperative haemorrhage ( P = 0.150), post‐operative mortality ( P = 0.810) and rejection ( P = 0.160). Conclusion The incidence of SFSS in grafts with a GRWR <0.8 is more than in GRWR ≥0.8; however, the low GRWR does not appear to impact perioperative outcomes or graft survival.