Copyright
©The Author(s) 2017.
World J Gastroenterol. Jun 21, 2017; 23(23): 4270-4277
Published online Jun 21, 2017. doi: 10.3748/wjg.v23.i23.4270
Published online Jun 21, 2017. doi: 10.3748/wjg.v23.i23.4270
Table 1 Patients’ demographic characteristics and diagnoses
| RL-LDLT (n = 199) | LL-LDLT (n = 19) | P value | |
| Median age (yr) (range) | 53 (17-72) | 52 (17-67) | 0.997 |
| Male:Female | 165:34 | 8:11 | 0.000 |
| Diagnosis | |||
| Liver cirrhosis | |||
| Cryptogenic | 3 | 1 | |
| Hepatitis B virus infection | 85 | 0 | |
| Hepatitis C virus infection | 15 | 5 | |
| Alcohol | 4 | 0 | |
| Infection of hepatitis B and C viruses | 2 | 0 | |
| Alcohol + hepatitis C virus infection | 3 | 0 | |
| Alcohol + hepatitis B virus infection | 1 | 0 | |
| Chronic active hepatitis B | 1 | 1 | |
| Fulminant hepatic failure | |||
| Cryptogenic | 1 | 1 | |
| Hepatitis B | 2 | 0 | |
| Autoimmune | 1 | 0 | |
| Drug-induced | 3 | 1 | |
| Biliary atresia | 2 | 0 | |
| Primary sclerosing cholangitis | 0 | 1 | |
| Primary biliary cirrhosis | 2 | 1 | |
| Graft failure | 4 | 0 | |
| Liver cirrhosis with acute deterioration | |||
| Cryptogenic | 2 | 0 | |
| Hepatitis B | 30 | 3 | |
| Alcohol | 1 | 0 | |
| Autoimmune | 1 | 0 | |
| Wilson's disease | 2 | 0 | |
| Chronic active hepatitis with acute flare | |||
| Hepatitis B | 32 | 1 | |
| Autoimmune | 1 | 0 | |
| Osler-Weber-Rendu syndrome | 1 | 0 | |
| Neuroendocrine syndrome | 0 | 1 | |
| Familial amyloid polyneuropathy | 0 | 1 | |
| Caroli disease | 0 | 1 | |
| Recurrent pyogenic cholangitis | 0 | 1 | |
| Hepatocellular carcinoma | 83 (41.7%) | 5 (26.3%) | 0.191 |
Table 2 Patients’ perioperative details
| RL-LDLT (n = 199) | LL-LDLT (n = 19) | P value | |
| Waiting time (d) | 11 (1-1354) | 16 (1-381) | 0.190 |
| Preoperative MELD score | 20 (6-50) | 14 (6-40) | 0.184 |
| GW (g) | 530 (320-715) | 410 (310-585) | 0.000 |
| GW/RSLV (%) | 42.8 (28.4-46.998) | 36.3 (27.3-46.96) | 0.000 |
| GW/RBW (%) | 0.77 (0.46-1.03) | 0.72 (0.49-1.04) | 0.236 |
| Graft cold ischemic time (min) | 105 (53-243) | 85 (69-134) | 0.007 |
| Recipient warm ischemic time (min) | 51 (25-89) | 45 (27-63) | 0.088 |
| Splenic artery ligation | 0 | 0 | - |
| Portosystemic shunt | 0 | 0 | - |
| Ligation of shunt | 2 (1.0%) | 0 | 1.000 |
| Blood transfusion (units) | 4 (0-39) | 2 (0-14) | 0.099 |
| Fresh frozen plasma transfusion (units) | 9 (0-38) | 6 (0-23) | 0.145 |
| Platelet transfusion (units) | 6 (0-32) | 3 (0-22) | 0.341 |
| Operation time (min) | 685 (400-1203) | 670 (485-1273) | 0.738 |
| Intensive care unit stay (d) | 4 (1-124) | 6 (2-16) | 0.055 |
| Hospital stay (d) | 17 (2-128) | 23 (10-68) | 0.072 |
| Follow-up period (d) | 86.9 (0.07-162.9) | 133.7 (0.53-159.2) | 0.054 |
Table 3 Survival outcomes and postoperative complications in recipients n (%)
| RL-LDLT (n = 199) | LL-LDLT (n = 19) | P value | |
| In-hospital death | 4 (2) | 1 (5.3) | 0.918 |
| Graft loss | 33 (16.6) | 5 (26.3) | 0.452 |
| Patient status - Alive:Dead | 169:30 | 15:4 | 0.722 |
| Graft survival | 0.049 | ||
| 1-yr | 98.50% | 89.50% | |
| 3-yr | 95.80% | 89.50% | |
| 5-yr | 95.20% | 89.50% | |
| Patient survival | 0.476 | ||
| 1-yr | 95.90% | 89.50% | |
| 3-yr | 90.80% | 89.50% | |
| 5-yr | 86.80% | 89.50% | |
| Postoperative complication1 | 0.105 | ||
| No complication | 92 (46.2) | 7 (36.8) | |
| Grade 1 | 42 (21.1) | 3 (15.8) | |
| Grade 2 | 21 (10.6) | 0 | |
| Grade 3a | 19 (9.5) | 5 (26.3) | |
| Grade 3b | 14 (7.0) | 3 (15.8) | |
| Grade 4a | 7 (3.5) | 0 | |
| Grade 4b | 2 (1.0) | 0 | |
| Grade 5 | 2 (1.0) | 1 (5.3) | |
| Reason for graft loss | |||
| Patient death | 28 | 3 | |
| Hepatic artery thrombosis | 1 | 0 | |
| Portal vein thrombosis | 1 | 0 | |
| PV/IVC thrombosis | 1 | 0 | |
| Recurrent Wilson's disease | 1 | 0 | |
| Biliary complication | 0 | 1 | |
| Reactivation of hepatitis C | 0 | 1 | |
| Rejection | 1 | 0 | |
| Cause of death | |||
| Acute myocardial infarction | 2 | 0 | |
| Chronic rejection | 1 | 0 | |
| Unknown | 2 | 0 | |
| Invasive aspergillosis | 1 | 0 | |
| Malignant cachexia | 16 | 0 | |
| Sepsis/multiorgan failure | 3 | 2 | |
| Subarachnoid hemorrhage | 1 | 0 | |
| Graft failure from PV/IVC thrombosis | 1 | 0 | |
| Lymphoproliferative disease | 1 | 0 | |
| Pulmonary hypertension | 1 | 0 | |
| Respiratory failure | 1 | 0 | |
| Chronic heart failure | 0 | 1 | |
| Reactivation of hepatitis C | 0 | 1 |
Table 4 Donor details
| RL-LDLT (n = 199) | LL-LDLT (n = 19) | P value | |
| Male:Female | 39:160 | 16:3 | 0.000 |
| Median age (yr) (range) | 34 (18-58) | 32 (18-55) | 0.847 |
| Death | 1 (0.5%) | 0 | 1.000 |
| Postoperative complication1 | 0.905 | ||
| No complication | 166 | 18 | |
| Grade 1 | 14 | 1 | |
| Grade 2 | 8 | 0 | |
| Grade 3a | 4 | 0 | |
| Grade 3b | 5 | 0 | |
| Grade 4a | 1 | 0 | |
| Grade 4b | 0 | 0 | |
| Grade 5 | 1 | 0 |
- Citation: She WH, Chok KS, Fung JY, Chan AC, Lo CM. Outcomes of right-lobe and left-lobe living-donor liver transplantations using small-for-size grafts. World J Gastroenterol 2017; 23(23): 4270-4277
- URL: https://www.wjgnet.com/1007-9327/full/v23/i23/4270.htm
- DOI: https://dx.doi.org/10.3748/wjg.v23.i23.4270