Does hepatic graft weight affect the reduction of spleen size after living donor liver transplantation?

OBJECTIVE

Our aim was to evaluate whether the reduction in spleen volume at 6 months after living donor liver transplantation (LDLT) was affected by the size of the right lobe liver graft.

PATIENTS AND METHODS

We analyzed 87 adult recipients of right lobe liver grafts who displayed preoperative splenomegaly: spleen volume>500 cm3 by computed tomographic (CT) volumetry. The recipients were grouped according to the graft weight-to-recipient weight ratio: GRWR>1 versus GRWR<1. The 2 groups were compared at 6 months after LDLT for mean postoperative spleen volume (SV) and mean SV change ratio 5, which was defined as [(SVpreop-SV6m)/SVpreop]x100%, where SVpreop and SV6m represent SV calculated based on CT examinations preoperatively and at 6 month follow-up after LDLT, respectively.

RESULTS

The GRWR ranged from 0.77 to 1.66. There were 53 patients with GRWR>1 and 34 with GRWR<1. Our analysis showed significant hepatic graft volume regeneration and SV reduction at 6 months after LDLT. The SV change ratio weakly but significantly correlated with the transplanted liver graft weight (Pearson correlation coefficient, r=0.274; P<.009). In the group GRWR>1, the mean postoperative SV and the mean SV change ratio were 632+/-220 cm3 and decreased by 32+/-11%, respectively. The mean postoperative SV and the mean SV change ratio in group GRWR<1 were 598+/-188 cm3 and decreased by 34+/-13%, respectively. There were no differences in mean postoperative SV and mean SV change ratios between the 2 groups.

CONCLUSION

LDLT using a right lobe graft resulted in a significant reduction of SV at 6 months after surgery, but there were no significant differences between recipients who received different sized right lobe liver grafts.