Department of Gastroenterology and Hepatology, Second Hospital of Lanzhou University, Lanzhou, China.
Key Laboratory of the Digestive System Tumors of Gansu Province, Lanzhou, China.
J Gastrointest Surg. 2020 Aug;24(8):1869-1879. doi: 10.1007/s11605-020-04598-3. Epub 2020 Apr 18.
Studies indicate that low graft-to-recipient weight ratio (GRWR) affect graft survival in adult-to-adult living donor liver transplantation. However, the potential role of GRWR in the prognosis of patients following living donor liver transplantation according to patient characteristics remains controversial. This study aimed to update the role of GRWR in patients following living donor liver transplantation.
PubMed, Embase, and Cochrane Library were comprehensively searched for studies comparing low GRWR (< 0.8%) with normal GRWR (≥ 0.8%) in the prognosis following living donor liver transplantation from inception to March 2019. The 1-, 3-, and 5-year summary survival rates, small-for-size syndrome (SFSS), perioperative mortality, biliary complications, postoperative bleeding, and acute rejection were calculated using the random-effects model.
Eighteen studies comprising 4001 patients were included. Patients with low GRWR were associated with lower 1-year and 3-year survival rates compared to patients with normal GRWR, while no significant difference was found in the association of 5-year survival rate with low and normal GRWRs. Moreover, the risk of SFSS significantly increased in patients with low GRWR. Finally, no significant differences were observed in the association of low and normal GRWRs with the risk of perioperative mortality, biliary complications, postoperative bleeding, and acute rejection.
The results of this study indicated that low GRWR was associated with poor prognosis for patients following living donor liver transplantation, especially in terms of 1- and 3-year survival rates and SFSS.
研究表明，成人对成人活体供肝移植中低移植物与受者体重比（GRWR）会影响移植物的存活率。然而，GRWR 在根据患者特征对活体供肝移植后患者预后中的潜在作用仍存在争议。本研究旨在更新 GRWR 在活体供肝移植后患者中的作用。
从建库至 2019 年 3 月，我们通过全面检索 PubMed、Embase 和 Cochrane Library 数据库，收集比较低 GRWR（<0.8%）与正常 GRWR（≥0.8%）在活体供肝移植后预后的研究。使用随机效应模型计算 1 年、3 年和 5 年的总生存率、小肝综合征（SFSS）、围手术期死亡率、胆道并发症、术后出血和急性排斥反应的发生率。
纳入 18 项研究共 4001 例患者。与正常 GRWR 患者相比，低 GRWR 患者的 1 年和 3 年生存率较低，但低 GRWR 与正常 GRWR 患者的 5 年生存率无显著差异。此外，低 GRWR 患者 SFSS 的风险显著增加。最后，低 GRWR 与正常 GRWR 与围手术期死亡率、胆道并发症、术后出血和急性排斥反应的风险均无显著相关性。
本研究结果表明，低 GRWR 与活体供肝移植后患者的不良预后相关，尤其是在 1 年和 3 年生存率和 SFSS 方面。
