Liver Graft-to-Spleen Volume Ratio as a Useful Predictive Factor of the Outcomes in Living Donor Liver Transplantation: A Retrospective Study
BackgroundIn living donor liver transplantation (LDLT), graft-to-recipient weight ratio (GRWR) <0. 8% is an important index for predicted portal hypertension, which may induce the graft small-for-size syndrome (SFSS). Recently, the value of graft-to-spleen volume ratio (GSVR) on predicted por...
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.855695/full |
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| author | Fei Xiao Fei Xiao Lin Wei Lin Wei Wei Qu Wei Qu Zhi-Gui Zeng Zhi-Gui Zeng Li-Ying Sun Li-Ying Sun Li-Ying Sun Ying Liu Ying Liu Hai-Ming Zhang Hai-Ming Zhang Yu-Le Tan Yu-Le Tan Jun Wang Jun Wang Zhi-Jun Zhu Zhi-Jun Zhu |
| author_facet | Fei Xiao Fei Xiao Lin Wei Lin Wei Wei Qu Wei Qu Zhi-Gui Zeng Zhi-Gui Zeng Li-Ying Sun Li-Ying Sun Li-Ying Sun Ying Liu Ying Liu Hai-Ming Zhang Hai-Ming Zhang Yu-Le Tan Yu-Le Tan Jun Wang Jun Wang Zhi-Jun Zhu Zhi-Jun Zhu |
| author_sort | Fei Xiao |
| collection | DOAJ |
| description | BackgroundIn living donor liver transplantation (LDLT), graft-to-recipient weight ratio (GRWR) <0. 8% is an important index for predicted portal hypertension, which may induce the graft small-for-size syndrome (SFSS). Recently, the value of graft-to-spleen volume ratio (GSVR) on predicted portal hypertension had been reported, whether without splenectomy prevent portal hypertension in transplantation remains disputed, we aimed to identify GSVR contributing to portal venous pressure (PVP) and outcomes without simultaneous splenectomy in LDLT.MethodsA retrospective study had been designed. Excluded patients with splenectomy, 246 recipients with LDLT between 2016 and 2020 were categorized into a low GSVR group and a normal GSVR group. Preoperative, intraoperative, and postoperative data were collected, then we explored different GSVR values contributing to portal hypertension after reperfusion.ResultsAccording to the first quartile of the distributed data, two groups were divided: low GSVR (<1.03 g/mL) and normal GSVR (>1.03 g/mL). For the donors, there were significant differences in donor age, graft type, liver size, GRWR, and GSVR (P < 0.05). Following the surgical factors, there were significant differences in blood loss and CRBC transfusion (P < 0.05). The low GSVR has demonstrated had a significant relationship with ascites drainage and portal venous flow after LDLT (P < 0.05). Meanwhile, low GSVR heralds worse results which covered platelet count, international normalized ratio (INR), and portal venous velocity. Kaplan–Meier analysis showed that there was a significant difference between the two groups, while the low GSVR group demonstrated worse recipients survival compared with the normal GSVR group (P < 0.05).ConclusionsWithout splenectomy, low GSVR was an important predictor of portal hypertension and impaired graft function after LDLT. |
| first_indexed | 2024-12-22T21:39:05Z |
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| id | doaj.art-eeb2d46c3ec1483a89092624c9def72b |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
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| last_indexed | 2024-12-22T21:39:05Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Surgery |
| spelling | doaj.art-eeb2d46c3ec1483a89092624c9def72b2022-12-21T18:11:40ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-03-01910.3389/fsurg.2022.855695855695Liver Graft-to-Spleen Volume Ratio as a Useful Predictive Factor of the Outcomes in Living Donor Liver Transplantation: A Retrospective StudyFei Xiao0Fei Xiao1Lin Wei2Lin Wei3Wei Qu4Wei Qu5Zhi-Gui Zeng6Zhi-Gui Zeng7Li-Ying Sun8Li-Ying Sun9Li-Ying Sun10Ying Liu11Ying Liu12Hai-Ming Zhang13Hai-Ming Zhang14Yu-Le Tan15Yu-Le Tan16Jun Wang17Jun Wang18Zhi-Jun Zhu19Zhi-Jun Zhu20Liver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaDepartment of Organ Transplantation, Liao Cheng People's Hospital, Liaocheng, ChinaLiver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaClinical Center for Pediatric Liver Transplantation, Capital Medical University, Beijing, ChinaLiver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaClinical Center for Pediatric Liver Transplantation, Capital Medical University, Beijing, ChinaLiver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaClinical Center for Pediatric Liver Transplantation, Capital Medical University, Beijing, ChinaLiver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaClinical Center for Pediatric Liver Transplantation, Capital Medical University, Beijing, ChinaDepartment of Critical Liver Diseases, Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaLiver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaClinical Center for Pediatric Liver Transplantation, Capital Medical University, Beijing, ChinaLiver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaClinical Center for Pediatric Liver Transplantation, Capital Medical University, Beijing, ChinaLiver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaClinical Center for Pediatric Liver Transplantation, Capital Medical University, Beijing, ChinaLiver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaClinical Center for Pediatric Liver Transplantation, Capital Medical University, Beijing, ChinaLiver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaClinical Center for Pediatric Liver Transplantation, Capital Medical University, Beijing, ChinaBackgroundIn living donor liver transplantation (LDLT), graft-to-recipient weight ratio (GRWR) <0. 8% is an important index for predicted portal hypertension, which may induce the graft small-for-size syndrome (SFSS). Recently, the value of graft-to-spleen volume ratio (GSVR) on predicted portal hypertension had been reported, whether without splenectomy prevent portal hypertension in transplantation remains disputed, we aimed to identify GSVR contributing to portal venous pressure (PVP) and outcomes without simultaneous splenectomy in LDLT.MethodsA retrospective study had been designed. Excluded patients with splenectomy, 246 recipients with LDLT between 2016 and 2020 were categorized into a low GSVR group and a normal GSVR group. Preoperative, intraoperative, and postoperative data were collected, then we explored different GSVR values contributing to portal hypertension after reperfusion.ResultsAccording to the first quartile of the distributed data, two groups were divided: low GSVR (<1.03 g/mL) and normal GSVR (>1.03 g/mL). For the donors, there were significant differences in donor age, graft type, liver size, GRWR, and GSVR (P < 0.05). Following the surgical factors, there were significant differences in blood loss and CRBC transfusion (P < 0.05). The low GSVR has demonstrated had a significant relationship with ascites drainage and portal venous flow after LDLT (P < 0.05). Meanwhile, low GSVR heralds worse results which covered platelet count, international normalized ratio (INR), and portal venous velocity. Kaplan–Meier analysis showed that there was a significant difference between the two groups, while the low GSVR group demonstrated worse recipients survival compared with the normal GSVR group (P < 0.05).ConclusionsWithout splenectomy, low GSVR was an important predictor of portal hypertension and impaired graft function after LDLT.https://www.frontiersin.org/articles/10.3389/fsurg.2022.855695/fullliving donor liver transplantationgraft-to-spleen volume ratiograft-to-recipient weight ratioportal hypertensionsplenectomy |
| spellingShingle | Fei Xiao Fei Xiao Lin Wei Lin Wei Wei Qu Wei Qu Zhi-Gui Zeng Zhi-Gui Zeng Li-Ying Sun Li-Ying Sun Li-Ying Sun Ying Liu Ying Liu Hai-Ming Zhang Hai-Ming Zhang Yu-Le Tan Yu-Le Tan Jun Wang Jun Wang Zhi-Jun Zhu Zhi-Jun Zhu Liver Graft-to-Spleen Volume Ratio as a Useful Predictive Factor of the Outcomes in Living Donor Liver Transplantation: A Retrospective Study Frontiers in Surgery living donor liver transplantation graft-to-spleen volume ratio graft-to-recipient weight ratio portal hypertension splenectomy |
| title | Liver Graft-to-Spleen Volume Ratio as a Useful Predictive Factor of the Outcomes in Living Donor Liver Transplantation: A Retrospective Study |
| title_full | Liver Graft-to-Spleen Volume Ratio as a Useful Predictive Factor of the Outcomes in Living Donor Liver Transplantation: A Retrospective Study |
| title_fullStr | Liver Graft-to-Spleen Volume Ratio as a Useful Predictive Factor of the Outcomes in Living Donor Liver Transplantation: A Retrospective Study |
| title_full_unstemmed | Liver Graft-to-Spleen Volume Ratio as a Useful Predictive Factor of the Outcomes in Living Donor Liver Transplantation: A Retrospective Study |
| title_short | Liver Graft-to-Spleen Volume Ratio as a Useful Predictive Factor of the Outcomes in Living Donor Liver Transplantation: A Retrospective Study |
| title_sort | liver graft to spleen volume ratio as a useful predictive factor of the outcomes in living donor liver transplantation a retrospective study |
| topic | living donor liver transplantation graft-to-spleen volume ratio graft-to-recipient weight ratio portal hypertension splenectomy |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.855695/full |
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