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Article: Increasing the recipient benefit/donor risk ratio by lowering the graft size requirement for living donor liver transplantation

TitleIncreasing the recipient benefit/donor risk ratio by lowering the graft size requirement for living donor liver transplantation
Authors
Issue Date2012
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jtoc/106570021
Citation
Liver Transplantation, 2012, v. 18 n. 9, p. 1078-1082 How to Cite?
AbstractIn living donor liver transplantation (LDLT), a right liver graft is larger than a left liver graft and hence leads to better recipient survival. However, in comparison with donor left hepatectomy, donor right hepatectomy carries a higher donor risk. We estimated the expansion of the applicability of left liver living donor liver transplantation (LLDLT) by lowering the graft weight (GW)/standard liver volume (SLV) ratio in increments of 5%. Consecutive LDLT cases were included in this study. The results of computed tomography volumetry provided the graft volume measurements, and the GW was derived from the graft volume with the conversion factor of 1.19 mL/g. We tried to estimate how many more times LLDLT would have been feasible if the GW/SLV requirement had been lowered to 40%, 35%, 30%, or 25%. In all, 361 consecutive donor-recipient pairs underwent LDLT. Right liver living donor liver transplantation (RLDLT) accounted for 95% of the LDLT cases. Most recipients were male (74.2%), and most donors were female (60.4%). The median GW/SLV ratio was 46% (47% for RLDLT and 37% for LLDLT, P < 0.001). Two of the 218 female donors donated the left liver, and 12 of the 93 female recipients received a left liver. In 147 of the 173 cases (85%) when the donor was female and the recipient was male, the GW/SLV ratio did not reach 30%. LLDLT could have been performed more often than 5% of the time if a lower GW/SLV requirement had been adopted. With GW/SLV ratios ≥ 40%, ≥ 35%, ≥ 30%, and ≥ 25%, the proportion of LLDLT cases would have risen from 5% to 5.8%, 12.5%, 29.1%, and 62.3%, respectively. LLDLT could have been performed approximately twice as often with every 5% reduction of the GW/SLV requirement. In conclusion, lowering the graft size requirement could improve the applicability of LLDLT and hence reduce donor risk. © 2012 American Association for the Study of Liver Diseases.
Persistent Identifierhttp://hdl.handle.net/10722/173028
ISSN
2015 Impact Factor: 3.951
2015 SCImago Journal Rankings: 1.763
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, SCen_US
dc.contributor.authorFan, STen_US
dc.contributor.authorChok, KSHen_US
dc.contributor.authorSharr, WWen_US
dc.contributor.authorDai, WCen_US
dc.contributor.authorFung, JYYen_US
dc.contributor.authorChan, KYen_US
dc.contributor.authorBalsarkar, DJen_US
dc.contributor.authorLo, CMen_US
dc.date.accessioned2012-10-30T06:26:39Z-
dc.date.available2012-10-30T06:26:39Z-
dc.date.issued2012en_US
dc.identifier.citationLiver Transplantation, 2012, v. 18 n. 9, p. 1078-1082en_US
dc.identifier.issn1527-6465en_US
dc.identifier.urihttp://hdl.handle.net/10722/173028-
dc.description.abstractIn living donor liver transplantation (LDLT), a right liver graft is larger than a left liver graft and hence leads to better recipient survival. However, in comparison with donor left hepatectomy, donor right hepatectomy carries a higher donor risk. We estimated the expansion of the applicability of left liver living donor liver transplantation (LLDLT) by lowering the graft weight (GW)/standard liver volume (SLV) ratio in increments of 5%. Consecutive LDLT cases were included in this study. The results of computed tomography volumetry provided the graft volume measurements, and the GW was derived from the graft volume with the conversion factor of 1.19 mL/g. We tried to estimate how many more times LLDLT would have been feasible if the GW/SLV requirement had been lowered to 40%, 35%, 30%, or 25%. In all, 361 consecutive donor-recipient pairs underwent LDLT. Right liver living donor liver transplantation (RLDLT) accounted for 95% of the LDLT cases. Most recipients were male (74.2%), and most donors were female (60.4%). The median GW/SLV ratio was 46% (47% for RLDLT and 37% for LLDLT, P < 0.001). Two of the 218 female donors donated the left liver, and 12 of the 93 female recipients received a left liver. In 147 of the 173 cases (85%) when the donor was female and the recipient was male, the GW/SLV ratio did not reach 30%. LLDLT could have been performed more often than 5% of the time if a lower GW/SLV requirement had been adopted. With GW/SLV ratios ≥ 40%, ≥ 35%, ≥ 30%, and ≥ 25%, the proportion of LLDLT cases would have risen from 5% to 5.8%, 12.5%, 29.1%, and 62.3%, respectively. LLDLT could have been performed approximately twice as often with every 5% reduction of the GW/SLV requirement. In conclusion, lowering the graft size requirement could improve the applicability of LLDLT and hence reduce donor risk. © 2012 American Association for the Study of Liver Diseases.en_US
dc.languageengen_US
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jtoc/106570021en_US
dc.relation.ispartofLiver Transplantationen_US
dc.titleIncreasing the recipient benefit/donor risk ratio by lowering the graft size requirement for living donor liver transplantationen_US
dc.typeArticleen_US
dc.identifier.emailChan, SC: chanlsc@hkucc.hku.hken_US
dc.identifier.emailFan, ST: stfan@hku.hken_US
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_US
dc.identifier.authorityChan, SC=rp01568en_US
dc.identifier.authorityFan, ST=rp00355en_US
dc.identifier.authorityLo, CM=rp00412en_US
dc.description.naturelink_to_OA_fulltexten_US
dc.identifier.doi10.1002/lt.23433en_US
dc.identifier.pmid22927142-
dc.identifier.scopuseid_2-s2.0-84862501510en_US
dc.identifier.hkuros211016-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84862501510&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume18en_US
dc.identifier.issue9en_US
dc.identifier.spage1078en_US
dc.identifier.epage1082en_US
dc.identifier.isiWOS:000307969300011-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridChan, SC=7404255575en_US
dc.identifier.scopusauthoridFan, ST=7402678224en_US
dc.identifier.scopusauthoridChok, KSH=6508229426en_US
dc.identifier.scopusauthoridSharr, WW=36864499000en_US
dc.identifier.scopusauthoridDai, WC=36186690700en_US
dc.identifier.scopusauthoridFung, JYY=55003370300en_US
dc.identifier.scopusauthoridChan, KY=55347739900en_US
dc.identifier.scopusauthoridBalsarkar, DJ=55348281700en_US
dc.identifier.scopusauthoridLo, CM=7401771672en_US

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