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Impact of graft-to-recipient weight ratio on small-for-size syndrome following living donor liver transplantation

Lookup NU author(s): Sanjay PandanaboyanaORCiD


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© 2018 Royal Australasian College of SurgeonsBackground: This meta-analysis aimed to compare living donor liver transplantation (LDLT) grafts with a graft-to-recipient weight ratio (GRWR) of <0.8 to grafts with a GRWR ≥0.8 with regards to small-for-size syndrome (SFSS) and short and longer term outcomes. Methods: An electronic search was performed of the MEDLINE, EMBASE and PubMed databases until December 2016 using both subject headings (MeSH) and free text. Pooled odds ratios and hazard ratios were calculated using fixed- and random-effects models for meta-analysis. Results: Eight studies including 1833 patients met the inclusion criteria. The rate of SFSS was 10% in the <0.8 group and 5% in the ≥0.8 group (odds ratio: 1.69 (1.09, 2.61) (P = 0.020)). No significant difference was noted between the two groups with regards to graft survival up to 5 years (hazard ratio: 1.31 (0.88, 1.94) (P = 0.190)). Similarly, no significant difference was noted in overall complications (P = 0.06), biliary (P = 0.290) or vascular complications (P = 0.190), perioperative haemorrhage (P = 0.150), post-operative mortality (P = 0.810) and rejection (P = 0.160). Conclusion: The incidence of SFSS in grafts with a GRWR <0.8 is more than in GRWR ≥0.8; however, the low GRWR does not appear to impact perioperative outcomes or graft survival.

Publication metadata

Author(s): Bell R, Pandanaboyana S, Upasani V, Prasad R

Publication type: Review

Publication status: Published

Journal: ANZ Journal of Surgery

Year: 2018

Volume: 88

Issue: 5

Pages: 415-420

Print publication date: 11/05/2018

Online publication date: 11/05/2018

Acceptance date: 18/08/2017

ISSN (print): 1445-1433

ISSN (electronic): 1445-2197

Publisher: Blackwell Publishing


DOI: 10.1111/ans.14245

PubMed id: 29752783