No reliable model for predicting early graft function and patient survival after living donor liver transplantation (LDLT) exists. The aim of this study was to establish a new formula for predicting early graft function and prognosis using technetium-99m galactosyl-human serum albumin (Tc-GSA) liver scintigraphy. The ratio of the hepatic uptake ratio of Tc-GSA to the clearance index of Tc-GSA (LHL/HH) was determined 7 days after LDLT. There were 22 patients with a ratio greater than 1.3 and 6 patients with a ratio less than 1.3. Graft function on the 14th postoperative day (POD) was compared between the 2 groups. A new formula to predict the LHL/HH score was established as follows: LHL/HH (predictive score) = 0.011 × graft weight (%) - 0.016 × donor age - 0.008 × Model for End-Stage Liver Disease score - 0. 15 × shunt (if present) + 1.757 (r2 = 0.497, P < 0.01). This predicted LHL/HH ratio was compared to the graft function on POD 14 for 110 LDLT patients. The total bilirubin JB) and prothrombin time international normalized ratio (PT-INR) in the group with an LHL/HH score ≥ 1.3 were lower than those in the group with an LHL/HH score < 1.3. The TB, PT-INR, and volume of ascites in the group with a predictive score ≥ 1.3 (n = 86) were lower than those in the group with a score < 1.3 (n = 24). The 6-month survival probability was improved in the group with a predictive score ≥ 1.3. In conclusion, this preoperative calculated LHL/HH score is correlated with graft function and short-term prognosis. Thus, this predictive model may allow transplant surgeons to use a living donor left lobe graft with greater confidence.
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