Outcome analysis in adult-to-adult living donor liver transplantation using the left lobe

Yuji Soejima, Mitsuo Shimada, Taketoshi Suehiro, Shoji Hiroshige, Mizuki Ninomiya, Satoko Shiotani, Noboru Harada, Ijichi Hideki, Yusuke Yonemura, Yoshihiko Maehara

研究成果: ジャーナルへの寄稿記事

85 引用 (Scopus)


Graft size problems remain the greatest limiting factor for expansion of living donor liver transplantation (LDLT) to the adult population. The result of adult-to-adult LDLT using the left lobe with special reference to graft size has not been fully evaluated to date. In this study, we evaluated the outcome of adult-to-adult LDLT using the left lobe and also analyze the impact of using small-for-size grafts on outcome. Thirty-six recipients who underwent adult-to-adult LDLT using the left lobe (n = 14) or left lobe plus caudate lobe (n = 22) were included in the study. Variables including preoperative and operative data, patient and graft survival, complications, and causes of graft loss were studied. Furthermore, the incidence of small-for-size syndrome and its impact on graft survival were studied. Mean graft volume (GV) was 420 ± 85 g (range, 260 to 620 g), which resulted in 38.2% ± 8.1% (range, 22.8% to 53.8%) of the recipient standard liver volume (SLV . Overall 1-year patient and graft survival rates were 85.7% and 82.9%, respectively. Seven grafts were lost. Small-for-size syndrome occurred in 7 of 16 patients (43.8%) with cirrhosis and only 1 of 20 patients (5.0%) without cirrhosis (P = .005). Recipients who developed small-for-size syndrome had inferior graft survival to those who did not (P = .07). In conclusion, adult-to-adult LDLTs were found to be feasible without affecting patient or graft survival. Small-for-size syndrome developed more frequently in patients with cirrhosis. Minimum GV in adult-to-adult LDLT should be 30% less than the recipient's SLV in patients without cirrhosis, whereas 45% less was required in patients with cirrhosis.

ジャーナルLiver Transplantation
出版物ステータス出版済み - 6 1 2003


All Science Journal Classification (ASJC) codes

  • Surgery
  • Hepatology
  • Transplantation


Soejima, Y., Shimada, M., Suehiro, T., Hiroshige, S., Ninomiya, M., Shiotani, S., ... Maehara, Y. (2003). Outcome analysis in adult-to-adult living donor liver transplantation using the left lobe. Liver Transplantation, 9(6), 581-586. https://doi.org/10.1053/jlts.2003.50114