Factors affecting graft survival after living donor liver transplantation

Living donor liver transplantation (LDLT) has been considered as an alternative option to resolve the shortage of cadaveric donor organs, despite the ethical aspects of the donor procedure. The objective of this study was to analyze the risk factors affecting graft survival in LDLT. From June 1996 to December 2002, 141 patients who underwent LDLT were retrospectively analyzed. Graft survival rates were 82.5%, 80%, 77.3%, and 77.3% at 6 months, 1 year, 3 years, and 5 years, respectively. The factors influencing graft survival in univariate analysis were graft-to-recipient body weight ratio (GRWR) less than 0.8% ( P = .0009), intraoperative transfusion of more than six packed RBC units in addition to the use of cell saver amounts ( P = .0001), left lobe grafts in adults causing small-for-size situations ( P = .0135), and donor age ( P = .0472). The multivariate analysis demonstrated that GRWR less than 0.8% ( P = .002) and intraoperative transfusion of more than six packed RBC units ( P = .014) were independent factors that decreased graft survival rates. The graft selection of greater than 0.8% of GRWR and reduction of intraoperative RBC transfusion improve graft survival.