Impact of graft‐to‐recipient weight ratio on small‐for‐size syndrome following living donor liver transplantation. Issue 5 (11th May 2018)

• Record Type: Journal Article
• Authors: Bell, Richard; Pandanaboyana, Sanjay; Upasani, Vivek; Prasad, Raj
• Is Part Of: ANZ journal of surgery. Volume 88:Issue 5(2018)
• Page Start: 415
• Page End: 420
• Publication Date: 2018-05-11
• Subjects: live donor -- liver transplantation -- small for size; Surgery -- Periodicals; 617.005
• DOI: 10.1111/ans.14245
• Languages: English
• ISSNs: 1445-1433

Abstract

Abstract : 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.