Unusual grafts for living-donor liver transplantation
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...
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | European Journal of Medical Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40001-023-01428-5 |
| _version_ | 1827723878532644864 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Seung Hyuk Yim |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-10T22:06:23Z |
| format | Article |
| id | doaj.art-73ea2d9d47e84bcca4d44207ebbcae41 |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-03-10T22:06:23Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-73ea2d9d47e84bcca4d44207ebbcae412023-11-19T12:46:44ZengBMCEuropean Journal of Medical Research2047-783X2023-10-0128111410.1186/s40001-023-01428-5Unusual grafts for living-donor liver transplantationSeung Hyuk Yim0Eun-Ki Min1Mun Chae Choi2Deok-Gie Kim3Dai Hoon Han4Dong Jin Joo5Jin Sub Choi6Myong Soo Kim7Gi Hong Choi8Jae Geun Lee9Department of Surgery, The Research Institute for Transplantation, Yonsei University College of MedicineDepartment of Surgery, The Research Institute for Transplantation, Yonsei University College of MedicineDepartment of Surgery, The Research Institute for Transplantation, Yonsei University College of MedicineDepartment of Surgery, The Research Institute for Transplantation, Yonsei University College of MedicineDepartment of Surgery, The Research Institute for Transplantation, Yonsei University College of MedicineDepartment of Surgery, The Research Institute for Transplantation, Yonsei University College of MedicineDepartment of Surgery, The Research Institute for Transplantation, Yonsei University College of MedicineDepartment of Surgery, The Research Institute for Transplantation, Yonsei University College of MedicineDepartment of Surgery, The Research Institute for Transplantation, Yonsei University College of MedicineDepartment of Surgery, The Research Institute for Transplantation, Yonsei University College of MedicineAbstract 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.https://doi.org/10.1186/s40001-023-01428-5Extended left liver plus caudate lobe graftRight anterior section graftRight posterior section graftDonor safetySurgical outcomes |
| spellingShingle | 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 Unusual grafts for living-donor liver transplantation European Journal of Medical Research Extended left liver plus caudate lobe graft Right anterior section graft Right posterior section graft Donor safety Surgical outcomes |
| title | Unusual grafts for living-donor liver transplantation |
| title_full | Unusual grafts for living-donor liver transplantation |
| title_fullStr | Unusual grafts for living-donor liver transplantation |
| title_full_unstemmed | Unusual grafts for living-donor liver transplantation |
| title_short | Unusual grafts for living-donor liver transplantation |
| title_sort | unusual grafts for living donor liver transplantation |
| topic | Extended left liver plus caudate lobe graft Right anterior section graft Right posterior section graft Donor safety Surgical outcomes |
| url | https://doi.org/10.1186/s40001-023-01428-5 |
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