Lei Jian-Yong, Yan Lu-Nan, Li Bo, Wen Tian-Fu, Wang Wen-Tao, Xu Ming-Qing, Yang Jia-Ying
Department of Liver and Vascular Surgery, Sichuan University, Chengdu, China.
Hepatogastroenterology. 2012 Jan-Feb;59(113):224-7. doi: 10.5754/hge11035.
BACKGROUND/AIMS: Graft size is recognized as one of the most important factors that affect prognosis of the liver recipients. This study determines whether the graft to recipient weight ratio (GRWR) alone can be used to select the liver donor and as an outcome predictor before living donor liver transplantation (LDLT).
LDLT patients (202) were divided into three groups according to the GRWR: Group S (n=46, GRWR <0.8); Group M (n=83, GRWR 0.8-1.0); Group L (n=73, GRWR >1.0). Recovery of graft function, incidence of small-for-size syndrome and rate of complications were compared among the three groups.
There were no significant differences in the baseline characteristics in both the donors and recipients, nor in the intensive care unit stay hours, re-operation rate, hospital stay after operation, Clavien System score and recovery of graft function after transplantation, among the three groups. The small-for-size syndrome rates were 13%, 7.23% and 11% in Groups S, M and B, and no significant difference was noted among the three groups.
GRWR may not be the only factor affecting recipient prognosis after LDLT. Local graft dysfunction such as impaired venous outflow, severity of disease and portal hyperperfusion in the recipient, and fatty liver in donor may influence the graft and thus the prognosis of transplantation.
背景/目的：移植物大小被认为是影响肝移植受者预后的最重要因素之一。本研究旨在确定仅使用移植物与受者体重比（GRWR）是否可用于选择活体肝移植（LDLT）前的肝脏供体并作为预后预测指标。
将202例LDLT患者根据GRWR分为三组：S组（n = 46，GRWR <0.8）；M组（n = 83，GRWR 0.8 - 1.0）；L组（n = 73，GRWR> 1.0）。比较三组患者的移植物功能恢复情况、小肝综合征发生率及并发症发生率。
三组患者供体和受体的基线特征、重症监护病房停留时间、再次手术率、术后住院时间、Clavien系统评分及移植后移植物功能恢复情况均无显著差异。S组、M组和L组的小肝综合征发生率分别为13%、7.23%和11%，三组间无显著差异。
GRWR可能不是影响LDLT术后受者预后的唯一因素。局部移植物功能障碍，如静脉流出道受损、受者疾病严重程度和门静脉高灌注以及供体脂肪肝等，可能影响移植物，进而影响移植预后。
