Outcomes of right-lobe and left-lobe living-donor liver transplantations using small-for-size grafts

Table 1 Patients’ demographic characteristics and diagnoses

	RL-LDLT (n = 199)	LL-LDLT (n = 19)	P value
Median age (yr) (range)	53 (17-72)	52 (17-67)	0.997
Male:Female	165:34	8:11	0.000
Diagnosis
Liver cirrhosis
Cryptogenic	3	1
Hepatitis B virus infection	85	0
Hepatitis C virus infection	15	5
Alcohol	4	0
Infection of hepatitis B and C viruses	2	0
Alcohol + hepatitis C virus infection	3	0
Alcohol + hepatitis B virus infection	1	0
Chronic active hepatitis B	1	1
Fulminant hepatic failure
Cryptogenic	1	1
Hepatitis B	2	0
Autoimmune	1	0
Drug-induced	3	1
Biliary atresia	2	0
Primary sclerosing cholangitis	0	1
Primary biliary cirrhosis	2	1
Graft failure	4	0
Liver cirrhosis with acute deterioration
Cryptogenic	2	0
Hepatitis B	30	3
Alcohol	1	0
Autoimmune	1	0
Wilson's disease	2	0
Chronic active hepatitis with acute flare
Hepatitis B	32	1
Autoimmune	1	0
Osler-Weber-Rendu syndrome	1	0
Neuroendocrine syndrome	0	1
Familial amyloid polyneuropathy	0	1
Caroli disease	0	1
Recurrent pyogenic cholangitis	0	1
Hepatocellular carcinoma	83 (41.7%)	5 (26.3%)	0.191

Table 2 Patients’ perioperative details

	RL-LDLT (n = 199)	LL-LDLT (n = 19)	P value
Waiting time (d)	11 (1-1354)	16 (1-381)	0.190
Preoperative MELD score	20 (6-50)	14 (6-40)	0.184
GW (g)	530 (320-715)	410 (310-585)	0.000
GW/RSLV (%)	42.8 (28.4-46.998)	36.3 (27.3-46.96)	0.000
GW/RBW (%)	0.77 (0.46-1.03)	0.72 (0.49-1.04)	0.236
Graft cold ischemic time (min)	105 (53-243)	85 (69-134)	0.007
Recipient warm ischemic time (min)	51 (25-89)	45 (27-63)	0.088
Splenic artery ligation	0	0	-
Portosystemic shunt	0	0	-
Ligation of shunt	2 (1.0%)	0	1.000
Blood transfusion (units)	4 (0-39)	2 (0-14)	0.099
Fresh frozen plasma transfusion (units)	9 (0-38)	6 (0-23)	0.145
Platelet transfusion (units)	6 (0-32)	3 (0-22)	0.341
Operation time (min)	685 (400-1203)	670 (485-1273)	0.738
Intensive care unit stay (d)	4 (1-124)	6 (2-16)	0.055
Hospital stay (d)	17 (2-128)	23 (10-68)	0.072
Follow-up period (d)	86.9 (0.07-162.9)	133.7 (0.53-159.2)	0.054

Data are presented as median (range). MELD: Model for End-stage Liver Disease; GW: Graft weight; RSLV: Recipient standard liver volume; RBW: Recipient body weight; LDLT: Living-donor liver transplantation; LL: Left-lobe; RL: Right-lobe.

Table 3 Survival outcomes and postoperative complications in recipients n (%)

	RL-LDLT (n = 199)	LL-LDLT (n = 19)	P value
In-hospital death	4 (2)	1 (5.3)	0.918
Graft loss	33 (16.6)	5 (26.3)	0.452
Patient status - Alive:Dead	169:30	15:4	0.722
Graft survival			0.049
1-yr	98.50%	89.50%
3-yr	95.80%	89.50%
5-yr	95.20%	89.50%
Patient survival			0.476
1-yr	95.90%	89.50%
3-yr	90.80%	89.50%
5-yr	86.80%	89.50%
Postoperative complication1			0.105
No complication	92 (46.2)	7 (36.8)
Grade 1	42 (21.1)	3 (15.8)
Grade 2	21 (10.6)	0
Grade 3a	19 (9.5)	5 (26.3)
Grade 3b	14 (7.0)	3 (15.8)
Grade 4a	7 (3.5)	0
Grade 4b	2 (1.0)	0
Grade 5	2 (1.0)	1 (5.3)
Reason for graft loss
Patient death	28	3
Hepatic artery thrombosis	1	0
Portal vein thrombosis	1	0
PV/IVC thrombosis	1	0
Recurrent Wilson's disease	1	0
Biliary complication	0	1
Reactivation of hepatitis C	0	1
Rejection	1	0
Cause of death
Acute myocardial infarction	2	0
Chronic rejection	1	0
Unknown	2	0
Invasive aspergillosis	1	0
Malignant cachexia	16	0
Sepsis/multiorgan failure	3	2
Subarachnoid hemorrhage	1	0
Graft failure from PV/IVC thrombosis	1	0
Lymphoproliferative disease	1	0
Pulmonary hypertension	1	0
Respiratory failure	1	0
Chronic heart failure	0	1
Reactivation of hepatitis C	0	1

¹Clavien grading. PV: Portal vein; IVC: Inferior vena cava; LDLT: Living-donor liver transplantation; LL: Left-lobe; RL: Right-lobe.

Table 4 Donor details

	RL-LDLT (n = 199)	LL-LDLT (n = 19)	P value
Male:Female	39:160	16:3	0.000
Median age (yr) (range)	34 (18-58)	32 (18-55)	0.847
Death	1 (0.5%)	0	1.000
Postoperative complication1			0.905
No complication	166	18
Grade 1	14	1
Grade 2	8	0
Grade 3a	4	0
Grade 3b	5	0
Grade 4a	1	0
Grade 4b	0	0
Grade 5	1	0

¹Clavien grading. LDLT: Living-donor liver transplantation; LL: Left-lobe; RL: Right-lobe.