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Unusual grafts for living-donor liver transplantation

Authors
 Seung Hyuk Yim  ;  Eun-Ki Min  ;  Mun Chae Choi  ;  Deok-Gie Kim  ;  Dai Hoon Han  ;  Dong Jin Joo  ;  Jin Sub Choi  ;  Myong Soo Kim  ;  Gi Hong Choi  ;  Jae Geun Lee 
Citation
 EUROPEAN JOURNAL OF MEDICAL RESEARCH, Vol.28(1) : 454, 2023-10 
Journal Title
EUROPEAN JOURNAL OF MEDICAL RESEARCH
ISSN
 0949-2321 
Issue Date
2023-10
MeSH
Alanine Transaminase ; Bilirubin ; End Stage Liver Disease* / surgery ; Humans ; Liver / surgery ; Liver Transplantation* / adverse effects ; Liver Transplantation* / methods ; Living Donors ; Retrospective Studies ; Severity of Illness Index ; Treatment Outcome
Keywords
Donor safety ; Extended left liver plus caudate lobe graft ; Right anterior section graft ; Right posterior section graft ; Surgical outcomes
Abstract
Purpose: Unusual grafts, including extended left liver plus caudate lobe, right anterior section, and right posterior section grafts, are alternatives to left and right lobe grafts for living-donor liver transplantation. This study aimed to investigate unusual grafts from the perspectives of recipients and donors.

Methods: From 2016 to 2021, 497 patients received living-donor liver transplantation at Severance Hospital. Among them, 10 patients received unusual grafts. Three patients received extended left liver plus caudate lobe grafts, two patients received right anterior section grafts, and five patients received right posterior section grafts. Liver volumetrics and anatomy were analyzed for all recipients and donors. We collected data on laboratory examinations (alanine aminotransferase, total bilirubin, international normalized ratio), imaging studies, graft survival, and complications. A 1:2 ratio propensity-score matching method was used to reduce selection bias and balance variables between the unusual and conventional graft groups.

Results: The median of Model for End-stage Liver Disease score of unusual graft recipients was 13.5 (interquartile range 11.5-19.3) and that of graft-recipient weight ratio was 0.767 (0.7-0.9). ABO incompatibility was observed in four cases. The alanine aminotransferase level, total bilirubin level, and international normalized ratio decreased in both recipients and donors. Unusual and conventional grafts had similar survival rates (p = 0.492). The right and left subgroups did not differ from each counter-conventional subgroup (p = 0.339 and p = 0.695, respectively). The incidence of major complications was not significantly different between unusual and conventional graft recipients (p = 0.513). Wound seromas were reported by unusual graft donors; the complication ratio was similar to that in conventional graft donors (p = 0.169).

Conclusion: Although unusual grafts require a complex indication, they may show feasible surgical outcomes for recipients with an acceptable donor complication.
Files in This Item:
T202306890.pdf Download
DOI
10.1186/s40001-023-01428-5
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Deok Gie(김덕기)
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Min, Eun-Ki(민은기)
Lee, Jae Geun(이재근) ORCID logo https://orcid.org/0000-0002-6722-0257
Yim, Seung Hyuk(임승혁) ORCID logo https://orcid.org/0000-0003-2146-3592
Joo, Dong Jin(주동진) ORCID logo https://orcid.org/0000-0001-8405-1531
Choi, Gi Hong(최기홍) ORCID logo https://orcid.org/0000-0002-1593-3773
Choi, Mun Chae(최문채)
Choi, Jin Sub(최진섭)
Han, Dai Hoon(한대훈) ORCID logo https://orcid.org/0000-0003-2787-7876
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/197322
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