Role of intelligent/interactive qualitative and quantitative analysis-three-dimensional estimated model in donor-recipient size mismatch following deceased donor liver transplantation

Table 1 Demographics, operational parameters and outcomes of recipients and donors

	Recipient	Donor
Demographics
Age (yr)	49.4 ± 12.8	48.1 ± 13.1
Male	102 (76.7)	111 (83.5)
Height (cm)	168.1 ± 10.2	170.6 ± 11.2
Weight (kg)	67.5 ± 18.0	73.7 ± 17.5
sTLV (mL)	1299 ± 482	1311 ± 267
eTLV by formula (mL)	1213 ± 212	1287 ± 207
eTLV by IQQA-3D (mL)	1311 ± 522	-
DRI	-	2.28 ± 0.42
Cold ischemia time (h)	-	5.9 ± 1.8
Liver disease
HBV/HCV	85 (63.9)	23 (17.3)
ALD	24 (18.0)	0
DILF	12 (9.0)	0
Steatosis	8 (6.0)	43 (32.3)
Hepatic carcinoma	42 (31.6)	0
Signs and symptoms
Moderate or severe ascites	69 (51.9)	-
Gastrointestinal bleeding	86 (64.7)	-
Hepatic encephalopathy	31 (23.3)	-
Operational parameters
Anhepatic phase time (min)	50.7 ± 9.0	-
IBL (mL)	3117 ± 1725	-
IBT (mL)	1949 ± 1749	-
Hospitalization Information
Tracheal extubation time (d)	1 (1-3)	-
ICU stay (d)	2 (1-6)	-
Postoperative hospital stay (d)	15 (11-23)	-
Complications
Massive intraoperative blood loss	95 (71.4)	-
EAD caused by SFSS	36 (27.1)	-
EAD caused by LFSS	20 (15.0)	-
Infection	49 (36.8)	-
Incision nonunion	29 (21.8)	-
Outcomes and follow-up
Perioperative mortality	29 (21.8)	-
Blood loss-specific mortality	7 (5.3)	-
EAD-specific mortality	17 (12.8)	-
All-cause mortality	46 (34.6)	-
Follow-up time (mo)	27 (9-44)	-

Values are mean ± SD, n (%), or median (interquartile range). sTLV: Standard total liver volume; eTLV: estimated total liver volume; DRI: Donor risk index; HBV: Hepatitis B virus; HCV: Hepatitis C virus; ALD: Alcoholic liver disease; DILF: Drug-induced liver failure; IBL: Intraoperative blood loss; IBT: Intraoperative blood transfusion; ICU: Intensive care unit; EAD: Early allograft dysfunction; SFSS: Small-for-size syndrome; LFSS: Large-for-size syndrome; IQQA-3D: Intelligent/interactive qualitative and quantitative analysis-three-dimensional.

Table 2 Univariate and multivariate logistic regression to predict massive intraoperative blood loss

	Univariate			Multivariate
	OR	95% CI	P value	OR	95% CI	P value
Recipient age	1.038	1.007-1.070	0.017			0.106
Male	0.835	0.336-2.074	0.697			0.815
sTLVi ≥ 1.24	22.00	4.804-100.8	< 0.001	18.43	3.809-89.15	< 0.001
Donor age	1.014	0.986-1.042	0.340
MD-FR combination	1.873	0.650-5.396	0.245
FD-MR combination	0.698	0.238-2.046	0.513
Graft steatosis (< 60%)	2.187	0.903-5.297	0.083
Cold ischemia time	1.005	0.815-1.239	0.963
DRI	1.074	0.437-2.644	0.876
HBV/HCV	1.225	0.564-2.661	0.608
ALD	11.82	1.535-90.99	0.018	9.371	1.112-78.98	0.040
DILF	0.165	0.406-0.586	0.005	0.226	0.052-0.983	0.047
Hepatic carcinoma	1.422	0.615-3.288	0.410
Gastrointestinal bleeding	2.393	1.104-5.188	0.027	3.954	1.502-10.41	0.005
Moderate or severe ascites	1.065	0.502-2.261	0.869
History of open upper abdominal surgery	2.108	0.737-6.032	0.164
Platelet count	1.000	0.955-1.005	0.914
PT	1.011	0.976-1.045	0.577
Child-Pugh grade C	2.347	0.961-5.731	0.061
MELD score	1.012	0.975-1.052	0.526
Anhepatic phase time	1.020	0.975-1.067	0.396

OR: Odds ratio; 95%CI: 95% confidence interval; sTLVi: Standard total liver volume index; MD-FR: Male donor-female recipient; FD-MR: Female donor-male recipient; DRI: Donor risk index; HBV: Hepatitis B virus; HCV: Hepatitis C virus; ALD: Alcoholic liver disease; DILF: Drug-induced liver failure; PT: Prothrombin time; MELD: Model for end-stage liver disease.

Table 3 Univariate and multivariate logistic regression to predict early allograft dysfunction

	EAD caused by SFSS						EAD caused by LFSS
	Univariate			Multivariate			Univariate			Multivariate
	OR	95%CI	P value	OR	95%CI	P value	OR	95%CI	P value	OR	95%CI	P value
Recipient age	0.980	0.948-1.013	0.235			0.992	1.062	1.014-1.113	0.012			0.069
Male	1.268	0.433-3.715	0.665			0.357	0.295	0.109-0.800	0.016			0.134
sTLVi ≤ 0.85/≥ 1.32	175.4	21.85-1407	< 0.001	21234	126-3585713	< 0.001	100.3	16.06-970.4	< 0.001	78.56	9.529-648.0	< 0.001
Donor age	0.992	0.961-1.025	0.645				1.003	0.967-1.040	0.887
MD-FR combination	0.504	0.139-1.833	0.298				10.61	3.693-30.47	< 0.001	6.540	1.617-26.45	0.008
FD-MR combination	0.916	0.242-3.464	0.897				1.923	0.557-6.637	0.301
Graft steatosis (< 60%)	0.065	0.009-0.502	0.009			0.444	2.424	0.923-6.368	0.072
Cold ischemia time	0.923	0.725-1.174	0.512				1.006	0.772-1.312	0.962
DRI	2.376	0.859-6.573	0.095			0.086	1.069	0.346-3.305	0.908
HBV/HCV positive graft	0.163	0.021-1.271	0.083				2.420	0.817-7.174	0.111
HBV/HCV	0.361	0.149-0.877	0.025	0.095	0.010-0.919	0.042	1.058	0.391-2.862	0.912
ALD	0.838	0.259-2.712	0.768				1.649	0.535-5.084	0.384
DILF	3.607	1.040-12.51	0.043			0.979	0.488	0.059-4.005	0.504
Hepatic carcinoma	0.480	0.167-1.381	0.173				0.493	0.154-1.579	0.234
Hepatic encephalopathy	1.739	0.667-4.534	0.258				3.384	1.249-9.167	0.016			0.186
History of ALSS	2.475	0.957-6.400	0.062				1.677	0.581-4.842	0.339
Child-Pugh grade C	18.85	2.408-147.5	0.005			0.319	2.200	0.563-8.598	0.257
MELD score	1.082	1.035-1.133	0.001	1.333	1.109-1.602	0.002	1.024	0.978-1.073	0.305
Anhepatic phase time	0.949	0.893-1.009	0.097				1.049	1.000-1.100	0.050			0.808

OR: Odds ratio; 95%CI: 95% confidence interval; sTLVi: Standard total liver volume index; MD-FR: Male donor-female recipient; FD-MR: Female donor-male recipient; DRI: Donor risk index; HBV: Hepatitis B virus; HCV: Hepatitis C virus; ALD: Alcoholic liver disease; DILF: Drug-induced liver failure; PT: Prothrombin time; MELD: Model for end-stage liver disease.