• J Coll Physicians Surg Pak · Mar 2022

    Small-for-Size versus Standard-Size Graft in Living Donor Liver Transplantation.

    • Abdul Wahab Dogar, Shams Uddin, Azhar Hussain, Kaleem Ullah, Abdul Ghaffar, and Syed Hasnain Abbas.
    • Department of Liver Transplant Unit, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Sindh, Pakistan.
    • J Coll Physicians Surg Pak. 2022 Mar 1; 32 (3): 293-297.

    ObjectiveTo compare the outcome of small-for-size grafts versus standard-size grafts regarding the frequency of postoperative complications, early graft dysfunction, and 1-year survival.Study DesignRetrospective cohort study.Place And Duration Of StudyPir Abdul Qadir Shah Jeelani Institute of Medical Sciences (PAQSJIMS) Hospital, Gambat, Sindh, Pakistan from March 2019 to April 2020.MethodologyA total of 147 living donor liver transplant recipients' data were retrospectively evaluated. Study participants were divided into two groups; small-for-size graft (GRWR <0.8%) and standard-size graft (GRWR >0.8%). Recipients' demographics, graft characteristics, operative parameters, postoperative complications, and graft survival were compared in both groups.ResultsOut of 147 recipients, 21 were found to have small-for-size graft, while 126 patients had the standard-size graft. Mean GRWR in small-for-size graft group was 0.73 + 0.4 (0.63-0.79), while 0.93 + 0.82 (0.81-3.0) in standard-size graft group. A statistically significant difference was found while comparing body mass index (p <0.001), hepatic venous reconstruction (p = 0.013), and liver attenuation index (p <0.001) between both study groups. While all other recipient and donor characteristics, demographical data, operative variables, postoperative lab, and complications were comparable in both groups (p >0.05). Kaplan-Meier analysis showed that 1-year survival rate for small-for-size graft recipients was 90.5%, while the survival rate for the standard-size graft was 96.0% (p = 0.272).ConclusionFrequency of post-op complications was comparable in both groups. The graft survival in small-for-size grafts was as good as for standard-size grafts. Key Words: Living donor liver transplantation, GRWR, Small-for-size graft, Standard-size graft.

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