Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2022; 10(16): 5414-5419
Published online Jun 6, 2022. doi: 10.12998/wjcc.v10.i16.5414
Successful living donor liver transplantation with a graft-to-recipient weight ratio of 0.41 without portal flow modulation: A case report
Seong Hoon Kim
Seong Hoon Kim, Center for Liver Cancer, National Cancer Center, Goyang 10408, Gyeonggi-do, South Korea
Author contributions: Kim SH conceived and designed the analysis, collected the data, performed the analysis, and wrote the paper.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report.
Conflict-of-interest statement: The author of this manuscript has no conflicts of interest to disclose.
CARE Checklist (2016) statement: I present the case in accordance with the CARE reporting checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Seong Hoon Kim, MD, PhD, Chief Doctor, Professor, Senior Scientist, Surgeon, Center for Liver Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 10408, Gyeonggi-do, South Korea. kshlj@hanmail.net
Received: September 17, 2021
Peer-review started: September 17, 2021
First decision: November 7, 2021
Revised: November 12, 2021
Accepted: April 22, 2022
Article in press: April 22, 2022
Published online: June 6, 2022
Processing time: 258 Days and 7.9 Hours
Abstract
BACKGROUND

There have been numerous efforts to lower the limit of minimum graft size to meet the metabolic demand of recipients in adult-to-adult living donor liver transplantation (LDLT). We experienced a successful case of LDLT using a very-small-for-size graft without portal flow modulation such as splenectomy or portocaval shunt.

CASE SUMMARY

A 49-year-old man (weighing 91 kg) suffering hepatocellular carcinoma accompanied with hepatitis B virus related cirrhosis underwent LDLT. The one and only voluntary donor was his 17-year-old daughter whose body weight was 50 kg with a body mass index (BMI) of 18.3. The procured right liver graft was 411 g with a real graft-to-recipient weight ratio (GRWR) of 0.41%, the smallest to be reported in the literature. Both the recipient and donor had an uneventful recovery and were discharged on days 15 and 8, respectively, with normal liver function. The father and daughter have had no complication so far and are still in good health with normal liver function 81 mo after LDLT.

CONCLUSION

Satisfactory outcomes can be achieved in LDLT with a GRWR as low as 0.41% even without using portal flow modulation in highly selected patients.

Keywords: Small-for-size graft; Living donor liver transplantation; Graft-to-recipient weight ratio; Case report

Core Tip: Satisfactory outcomes was achieved in living donor liver transplantation with a graft-to-recipient weight ratio as low as 0.41%, the smallest to be reported in the literature, even without using portal flow modulation in a highly selected patient.