CAJ | 학술논문

BACKGROUND:?The? low? graft-to-recipient? weight? ratio?(GRWR)?in?adult-to-adult?living?donor?liver?transplantation?(LDLT)?is?one?of?the?major?risk?factors?affecting?graft?survival.?The?goal?of?this?study?was?to?evaluate?whether?the?lower?limit?of?the?GRWR?can?be?safely?reduced?without?portal?pressure?modulation?in?right-lobe?LDLT. <br> METHODS:?From?2005?to?2011,?317?consecutive?patients?from?a?single?institute?underwent?LDLT?with?right-lobe?grafts?without?portal?pressure?modulation.?Of?these,?23?had?a?GRWR?of?less?than?0.7%?(group?A),?27?had?a?GRWR?of?≥0.7%,?<0.8%?(group?B),?and?267?had?a?GRWR?of?more?than?and?equal?to?0.8%?(group?C).? Medical? records,? including? recipient,? donor,? operation?factors,?laboratory?ifndings?and?complications?were?reviewed?retrospectively. <br> RESULTS:?The? baseline? demographics? showed? low? model?for?end-stage?liver?disease?score?(mean?16.3±8.9)?and?high?percentage?of?hepatocellular?carcinoma?(231?patients,?72.9%).?Three?groups?by?GRWR?demonstrated?similar?characteristics?except?recipient?body?mass?index?and?donor?gender.?For?small-for-size?syndrome,?there?were?3?(13.0%)?in?group?A,?1?(3.7%)?in?group?B,?and?2?patients?(0.7%)?in?group?C?(P<0.001).?Hepatic?artery?thrombosis?was?more?frequently?observed?in?group?A?than?in?groups?B?and?C?(8.7%?vs?3.7%?vs?1.9%,?P=0.047).?However,?among?the?three?groups,?graft?survival?rates?at?1?year?(100%?vs?96.3%?vs?93.6%)?and?3?years?(91.7%?vs?73.2%?vs?88.1%)?were? not? different? (P=0.539).? In? laboratory? measurements,?there?was?no?group?difference?in?total?bilirubin?and?albumin.?However,?prothrombin?time?was?longer?in?group?A?within?postoperative?1?week?and?platelet?count?was?lower?in?groups?A?and?B?within?postoperative?1?month. <br> CONCLUSION:?A?GRWR?lower?to?0.7%?is?safe?and?does?not?need?to?modulate?portal?pressure?in?adult-to-adult?LDLT?using?the?right-lobe?in?favorable?conditions?including?low?model?for?end-stage?liver?disease?score.