Graft‐to‐recipient weight ratio threshold adjusted to the model for end‐stage liver disease score for living donor liver transplantation
The graft‐to‐recipient weight ratio (GRWR) is an important selection criterion for living donor liver transplantation (LDLT). The generally accepted threshold is known to be 0.8%. We believe that this threshold can be reduced under certain conditions. The aim of this study was to evaluate the result...
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| Veröffentlicht in: | Liver transplantation 2016-12, Vol.22 (12), p.1643-1648 |
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| creator | Alim, Altan Erdogan, Yalcin Yuzer, Yildiray Tokat, Yaman Oezcelik, Arzu |
| description | The graft‐to‐recipient weight ratio (GRWR) is an important selection criterion for living donor liver transplantation (LDLT). The generally accepted threshold is known to be 0.8%. We believe that this threshold can be reduced under certain conditions. The aim of this study was to evaluate the results of these patients with GRWR |
| doi_str_mv | 10.1002/lt.24523 |
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The generally accepted threshold is known to be 0.8%. We believe that this threshold can be reduced under certain conditions. The aim of this study was to evaluate the results of these patients with GRWR < 0.8%. Between 2004 and 2015, 649 patients underwent right lobe LDLT for end‐stage liver disease in adult patients. All recipients who had GRWR < 0.8% were identified. The data of these patients were retrospectively analyzed and compared to patients with GRWR ≥ 0.8%. There were 43 patients with GRWR < 0.8%. Out of these patients, 7 (16%) had GRWR of 0.6%. The median Model for End‐Stage Liver Disease (MELD) score was 15, and the median donor age was 30 years. Anterior segment drainage was ensured. Portal inflow modulation was performed by splenic artery ligation according to the portal flow. Postoperative complications were seen in 6 (14%) patients. Of all 43 patients, 3 (7%) died perioperatively within 1 month, and 1 (2%) patient underwent retransplantation due to graft failure. The mean hospital stay was 18 days. The 1‐year survival rate was 93%. None of the patients had a laboratory MELD score above 20. The comparison of the results with the patients who had GRWR ≥ 0.8% has shown no significant difference, except MELD score, body mass index (BMI), and rate of anterior segment drainage. The GRWR can be decreased even to 0.6% if the MELD score is below 20, donor age is below 45 years, and there are no signs for any hepatosteatosis of the donor graft. In these patients, it is essential that the anterior segment drainage is secured and the portal inflow modulation is performed according to the portal flow. Liver Transplantation 22 1643–1648 2016 AASLD.</description><identifier>ISSN: 1527-6465</identifier><identifier>EISSN: 1527-6473</identifier><identifier>DOI: 10.1002/lt.24523</identifier><identifier>PMID: 27509534</identifier><identifier>CODEN: LITRFO</identifier><language>eng</language><publisher>United States: Wolters Kluwer Health, Inc</publisher><subject>Adult ; Body Mass Index ; Donor Selection - methods ; Drainage ; End Stage Liver Disease - surgery ; Female ; Graft Rejection - surgery ; Humans ; Length of Stay ; Liver - anatomy & histology ; Liver Circulation ; Liver diseases ; Liver Transplantation - methods ; Liver Transplantation - mortality ; Living Donors ; Male ; Middle Aged ; Organ Size ; Portal System - physiopathology ; Postoperative Complications - epidemiology ; Reoperation ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Survival Rate ; Treatment Outcome</subject><ispartof>Liver transplantation, 2016-12, Vol.22 (12), p.1643-1648</ispartof><rights>2016 by the American Association for the Study of Liver Diseases.</rights><rights>2016 by the American Association for the Study of Liver Diseases</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4153-2d04532d9563fa37490bc2fd3fa1e6938de86197da6ea8509e162c00860667643</citedby><cites>FETCH-LOGICAL-c4153-2d04532d9563fa37490bc2fd3fa1e6938de86197da6ea8509e162c00860667643</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flt.24523$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flt.24523$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27509534$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alim, Altan</creatorcontrib><creatorcontrib>Erdogan, Yalcin</creatorcontrib><creatorcontrib>Yuzer, Yildiray</creatorcontrib><creatorcontrib>Tokat, Yaman</creatorcontrib><creatorcontrib>Oezcelik, Arzu</creatorcontrib><title>Graft‐to‐recipient weight ratio threshold adjusted to the model for end‐stage liver disease score for living donor liver transplantation</title><title>Liver transplantation</title><addtitle>Liver Transpl</addtitle><description>The graft‐to‐recipient weight ratio (GRWR) is an important selection criterion for living donor liver transplantation (LDLT). The generally accepted threshold is known to be 0.8%. We believe that this threshold can be reduced under certain conditions. The aim of this study was to evaluate the results of these patients with GRWR < 0.8%. Between 2004 and 2015, 649 patients underwent right lobe LDLT for end‐stage liver disease in adult patients. All recipients who had GRWR < 0.8% were identified. The data of these patients were retrospectively analyzed and compared to patients with GRWR ≥ 0.8%. There were 43 patients with GRWR < 0.8%. Out of these patients, 7 (16%) had GRWR of 0.6%. The median Model for End‐Stage Liver Disease (MELD) score was 15, and the median donor age was 30 years. Anterior segment drainage was ensured. Portal inflow modulation was performed by splenic artery ligation according to the portal flow. Postoperative complications were seen in 6 (14%) patients. Of all 43 patients, 3 (7%) died perioperatively within 1 month, and 1 (2%) patient underwent retransplantation due to graft failure. The mean hospital stay was 18 days. The 1‐year survival rate was 93%. None of the patients had a laboratory MELD score above 20. The comparison of the results with the patients who had GRWR ≥ 0.8% has shown no significant difference, except MELD score, body mass index (BMI), and rate of anterior segment drainage. The GRWR can be decreased even to 0.6% if the MELD score is below 20, donor age is below 45 years, and there are no signs for any hepatosteatosis of the donor graft. In these patients, it is essential that the anterior segment drainage is secured and the portal inflow modulation is performed according to the portal flow. Liver Transplantation 22 1643–1648 2016 AASLD.</description><subject>Adult</subject><subject>Body Mass Index</subject><subject>Donor Selection - methods</subject><subject>Drainage</subject><subject>End Stage Liver Disease - surgery</subject><subject>Female</subject><subject>Graft Rejection - surgery</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Liver - anatomy & histology</subject><subject>Liver Circulation</subject><subject>Liver diseases</subject><subject>Liver Transplantation - methods</subject><subject>Liver Transplantation - mortality</subject><subject>Living Donors</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Organ Size</subject><subject>Portal System - physiopathology</subject><subject>Postoperative Complications - epidemiology</subject><subject>Reoperation</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>1527-6465</issn><issn>1527-6473</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kclKBDEQhoMo7uATSMCLl9bs3X0UcYMBL3puYqd6JkOmMyZpZW4-gfiMPokZxwUEL0mq-Piqwo_QASUnlBB26tIJE5LxNbRNJSsLJUq-_vNWcgvtxDglhFJZk020xUpJasnFNnq9CrpL7y9vyecjQGvnFvqEn8GOJwkHnazHaRIgTrwzWJvpEBMYnJZdwDNvwOHOBwy9yYKY9Biws08QsLERdAQcWx_gk8l924-x8f2qyFAKuo9zp_u0nNTvoY1Ouwj7X_cuur-8uDu_Lka3VzfnZ6OiFVTyghkiJGemlop3mpeiJg8t60wuKKiaVwYqRevSaAW6yn8FqlhLSKWIUqUSfBcdr7zz4B8HiKmZ2diCy4uAH2JDK8FkXdalyujRH3Tqh9Dn7ZaUJFJQwX6FbfAxBuiaebAzHRYNJc0yo8al5jOjjB5-CYeHGZgf8DuUDBQr4Nk6WPwrakZ3K-EHii-ePw</recordid><startdate>201612</startdate><enddate>201612</enddate><creator>Alim, Altan</creator><creator>Erdogan, Yalcin</creator><creator>Yuzer, Yildiray</creator><creator>Tokat, Yaman</creator><creator>Oezcelik, Arzu</creator><general>Wolters Kluwer Health, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201612</creationdate><title>Graft‐to‐recipient weight ratio threshold adjusted to the model for end‐stage liver disease score for living donor liver transplantation</title><author>Alim, Altan ; Erdogan, Yalcin ; Yuzer, Yildiray ; Tokat, Yaman ; Oezcelik, Arzu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4153-2d04532d9563fa37490bc2fd3fa1e6938de86197da6ea8509e162c00860667643</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Body Mass Index</topic><topic>Donor Selection - methods</topic><topic>Drainage</topic><topic>End Stage Liver Disease - surgery</topic><topic>Female</topic><topic>Graft Rejection - surgery</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Liver - anatomy & histology</topic><topic>Liver Circulation</topic><topic>Liver diseases</topic><topic>Liver Transplantation - methods</topic><topic>Liver Transplantation - mortality</topic><topic>Living Donors</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Organ Size</topic><topic>Portal System - physiopathology</topic><topic>Postoperative Complications - epidemiology</topic><topic>Reoperation</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Alim, Altan</creatorcontrib><creatorcontrib>Erdogan, Yalcin</creatorcontrib><creatorcontrib>Yuzer, Yildiray</creatorcontrib><creatorcontrib>Tokat, Yaman</creatorcontrib><creatorcontrib>Oezcelik, Arzu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Liver transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Alim, Altan</au><au>Erdogan, Yalcin</au><au>Yuzer, Yildiray</au><au>Tokat, Yaman</au><au>Oezcelik, Arzu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Graft‐to‐recipient weight ratio threshold adjusted to the model for end‐stage liver disease score for living donor liver transplantation</atitle><jtitle>Liver transplantation</jtitle><addtitle>Liver Transpl</addtitle><date>2016-12</date><risdate>2016</risdate><volume>22</volume><issue>12</issue><spage>1643</spage><epage>1648</epage><pages>1643-1648</pages><issn>1527-6465</issn><eissn>1527-6473</eissn><coden>LITRFO</coden><abstract>The graft‐to‐recipient weight ratio (GRWR) is an important selection criterion for living donor liver transplantation (LDLT). The generally accepted threshold is known to be 0.8%. We believe that this threshold can be reduced under certain conditions. The aim of this study was to evaluate the results of these patients with GRWR < 0.8%. Between 2004 and 2015, 649 patients underwent right lobe LDLT for end‐stage liver disease in adult patients. All recipients who had GRWR < 0.8% were identified. The data of these patients were retrospectively analyzed and compared to patients with GRWR ≥ 0.8%. There were 43 patients with GRWR < 0.8%. Out of these patients, 7 (16%) had GRWR of 0.6%. The median Model for End‐Stage Liver Disease (MELD) score was 15, and the median donor age was 30 years. Anterior segment drainage was ensured. Portal inflow modulation was performed by splenic artery ligation according to the portal flow. Postoperative complications were seen in 6 (14%) patients. Of all 43 patients, 3 (7%) died perioperatively within 1 month, and 1 (2%) patient underwent retransplantation due to graft failure. The mean hospital stay was 18 days. The 1‐year survival rate was 93%. None of the patients had a laboratory MELD score above 20. The comparison of the results with the patients who had GRWR ≥ 0.8% has shown no significant difference, except MELD score, body mass index (BMI), and rate of anterior segment drainage. The GRWR can be decreased even to 0.6% if the MELD score is below 20, donor age is below 45 years, and there are no signs for any hepatosteatosis of the donor graft. In these patients, it is essential that the anterior segment drainage is secured and the portal inflow modulation is performed according to the portal flow. Liver Transplantation 22 1643–1648 2016 AASLD.</abstract><cop>United States</cop><pub>Wolters Kluwer Health, Inc</pub><pmid>27509534</pmid><doi>10.1002/lt.24523</doi><tpages>6</tpages></addata></record> |
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| ispartof | Liver transplantation, 2016-12, Vol.22 (12), p.1643-1648 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Alma/SFX Local Collection |
| subjects | Adult Body Mass Index Donor Selection - methods Drainage End Stage Liver Disease - surgery Female Graft Rejection - surgery Humans Length of Stay Liver - anatomy & histology Liver Circulation Liver diseases Liver Transplantation - methods Liver Transplantation - mortality Living Donors Male Middle Aged Organ Size Portal System - physiopathology Postoperative Complications - epidemiology Reoperation Retrospective Studies Risk Factors Severity of Illness Index Survival Rate Treatment Outcome |
| title | Graft‐to‐recipient weight ratio threshold adjusted to the model for end‐stage liver disease score for living donor liver transplantation |
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