Feasibility of small size graft following living donor liver transplantation / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the complication rate and survival rate of the patients whose graft-recipient weight ratio (GRWR) less than 0.8% following living donor liver transplantation (LDLT).</p><p><b>METHODS</b>There were 92 consecutive LDLT patients from January 2001 to December 2007 in West China Hospital, Sichuan University. There were 85 males and 7 females aged from 18 to 65 years old (averaged, 42 years old) and among which 89 patients were involved in the study. There were 15 patients whose GRWR less than 0.8% (group 1), while other 74 recipients were in group 2. Comparing the two groups' complication rates and survival rates and finding out the potential influencing factor of small-size-graft recipients' survival rate.</p><p><b>RESULTS</b>The survival rates of group 1 and group 2 were 73.3% (11/15) and 71.6% (53/74), respectively. The grade II-V complication rates of group 1 and group 2 were 46.7% (7/15) and 48.6% (36/74), respectively. There were no difference in survival rates (chi(2) = 0.058, P = 0.811) and complication rates (chi(2) = 0.000, P = 1.000) between the two groups. Ascites volume of group 1 and group 2 were (1532 +/- 322) ml and (1466 +/- 110) ml, respectively (t = 0.234, P = 0.815). The condition of the graft's middle hepatic vein had significant influence on small-size-liver recipients' survival rates (chi(2) = 6.821, P = 0.009).</p><p><b>CONCLUSIONS</b>GRWR < 0.8% is not the limitation of the living donor liver transplantation but the outflow tract of the graft must be unobstructed.</p>

Analysis of risk factors for marginal donors in living donor liver transplantation / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To analyze risk factors of marginal donors in living donor liver transplantation.</p><p><b>METHODS</b>98 living donor liver transplantation (LDLT) patients over the 7-year period from 2001 to 2007 in our transplantation center were retrospected. Potential risk factors, including donor age, gender-mismatch, steatotic donors and graft-recipient weight ratio (GRWR), and their relationship with 6-month patient survival rate were analyzed.</p><p><b>RESULTS</b>The 4 patients received livers with more than 30% steatosis died within 6 months, and 6-month survival rate was 91.7% in patients received livers with less than 30% steatosis. The 6-month survival rate was 86.9% and 87.8% in patients with grafts of GRWR more than 0.8% and in patients with graft of GRWR less than 0.8%, respectvely (x2=0.022, P more than 0.05), however, middle hepatic vein reconstruction significantly affected the survival rate of small-size-liver recipients (x2=10.612, P less than 0.01). Donor age and gender-mismatch were not associated with the survival rate of recipients (P more than 0.05).</p><p><b>CONCLUSIONS</b>Steatosis is an important risk factor in living donor liver transplantation. Lower GRWR is not a limitation but we must reconsider its importance in liver transplantation. The donor age and gender-mismatch are not associated with the survival rate of recipients.</p>