Outcome of patients undergoing right lobe living donor liver transplantation with small-for-size grafts

Table 1 Clinical features of the recipients of liver grafts with an actuarial graft-to-recipient weight ratio < 0.8% and those with an actuarial graft-to-recipient weight ratio ≥ 0.8% n (%)

Variable	Total (n = 196)	Group A (n = 45)	Group B (n = 151)	P value
Recipient factors
Age (yr)	42.60 ± 9.05	42.60 ± 8.90	42.60 ± 9.13	0.673
Sex (male/female)	171/25	40/5	131/20	0.706
MELD score	16.42 ± 9.86	13.87 ± 9.09	17.19 ± 9.97	0.012a
Child-Pugh score	7.71 ± 2.12	7.27 ± 2.08	7.85 ± 2.20	0.118
aGRWR (%)	0.93 ± 0.18	0.71 ± 0.07	0.99 ± 0.15	< 0.001a
ABO-compatibility (yes/no)	161/35	36/9	125/26	0.669
Median follow-up (mo)	54.3	48.8	57.8	0.033a
2001-2005/2006-2010	22/174	2/43	20/131	0.101
ICU stay (h)	307.32 ± 305.86	277.07 ± 270.91	316.34 ± 315.81	0.189
Hospitalization time (d)	39.45 ± 25.21	38.84 ± 22.49	39.64 ± 26.03	0.970
Pre-transplant complications
Encephalopathy	21 (10.71)	4 (8.89)	17 (11.26)	0.860
GI bleeding	12 (6.12)	4 (8.89)	8 (5.30)	0.598
Peritonitis	8 (4.08)	0	8 (5.30)	0.251
Uncontrolled ascites	37 (18.88)	7 (15.56)	30 (19.87)	0.516
Renal insufficiency	7 (3.57)	0	7 (4.64)	0.311
Etiology				< 0.001a
Hepatic malignancy	89 (45.41)	28 (62.22)	61 (40.40)	0.010
Viral cirrhosis	66 (33.67)	7 (15.56)	59 (39.07)	0.003
Non-viral cirrhosis	11 (5.61)	4 (8.89)	7 (4.64)	0.472
Cholestasis	12 (6.12)	1 (2.22)	11 (7.28)	0.374
Acute liver failure	11 (5.61)	4 (8.89)	8 (5.30)	0.598
Other	6 (3.06)	1 (2.22)	5 (3.31)	0.710
Donor factors
Age (yr)	34.97 ± 10.20	34.29 ± 9.97	35.18 ± 10.30	0.727
Sex (male/female)	121/75	32/13	89/62	0.140
Body mass index	23.00 ± 2.55	22.96 ± 3.15	23.01 ± 2.36	0.654
Relationship (blood-related/non-blood-related)	20.41%/79.59%	13.33%/86.67%	22.52%/77.48%	0.180
	40/156	6/39	34/117
Operative factors
Operative time (min)	659.02 ± 132.78	662.24 ± 113.65	658.05 ± 138.30	0.472
Blood loss (mL)	2183.93 ± 2022.02	2014.44 ± 1765.92	2234.44 ± 2095.04	0.444
Ahepatic duration (min)	93.36 ± 41.82	87.47 ± 30.94	95.11 ± 44.49	0.412
MHV tributary drainage1	124 (63.27)	31 (68.89)	93 (61.69)	0.373
Concurrent splenectomy	11 (5.61)	3 (6.67)	8 (5.30)	0.726
Types of biliary reconstruction2	180/16	44/1	136/15	0.178
Complications after LDLT
Postoperative bleeding	8 (4.08)	1 (2.22)	7 (4.64)	0.773
Acute rejection	9 (4.59)	2 (4.44)	7 (4.64)	0.957
Vascular complications	7 (3.57)	1 (2.22)	6 (3.97)	0.922
Biliary complications	21 (10.71)	5 (11.11)	16 (10.60)	0.922
SFSS	16 (8.16)	7 (15.56)	9 (5.96)	0.080

¹MHV tributary drainage includes MHV tributary reconstruction and MHV trunk inclusion;

²Types of biliary reconstruction type includes duct-to-duct anastomosis and Roux-en-Y hepaticojejunostomy. GI: Gastrointestinal; MELD: Model for End-Stage Liver Disease; aGRWR: Actuarial graft-to-recipient weight ratio; MHV: Middle hepatic vein; LDLT: Living donor liver transplantation; SFSS: Small-for-size syndrome.

^aP < 0.05.

Table 2 Risk factors for graft survival in patients undergoing living donor liver transplantation with small-for-size graft, results of the univariate analysis

Variable	P value
Recipient factors
Age (yr)	0.942
Sex (male/female)	0.410
MELD score	0.150
Child-Pugh score	0.754
GRWR (%)	0.545
ABO-compatibility	0.185
2001-2005/2006-2010	0.634
ICU stay (h)	0.065
Hospitalization time (d)	0.868
Pre-transplant complications
Encephalopathy	0.688
GI bleeding	0.688
Peritonitis	-
Uncontrolled ascites	0.563
Renal insufficiency	-
Etiology
Hepatic malignancy	-
Viral cirrhosis	-
Non-viral cirrhosis	-
Cholestasis	-
Acute liver failure	-
Other	-
Donor factors
Age (yr)	0.094
Sex (male/female)	0.201
Body mass index	0.253
Relationship	0.537
Operative factors
Operative time (min)	0.245
Blood loss (mL)	0.310
Ahepatic duration (min)	0.605
MHV tributary drainage1	0.064
Concurrent splenectomy	0.358
Types of biliary reconstruction2	0.730
Complications after LDLT
Postoperative bleeding	0.730
Acute rejection	0.730
Vascular complications	0.730
Biliary complications	0.469
SFSS	< 0.001a

¹Middle hepatic vein (MHV) tributary drainage includes MHV tributary reconstruction and MHV trunk inclusion;

²Types of biliary reconstruction type includes duct-to-duct anastomosis and Roux-en-Y hepaticojejunostomy. LDLT: Living donor liver transplantation; MELD: Model for end-stage liver disease; GRWR: Graft-to-recipient weight ratio; GI: Gastrointestinal; ICU: Intensive care unit.

^aP < 0.05.