Determination of the safe range of graft size mismatch using body surface area index in deceased liver transplantation

Kyota Fukazawa, Yoshitsugu Yamada, Seigo Nishida, Taizo Hibi, Kristopher Arheart, Ernesto Pretto

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

In live donor liver transplantation, rigorous standardized criteria for matching of liver volume between donor and recipient have prevented graft loss because of size mismatch. In deceased whole liver transplantation, the safe donor-recipient size mismatch range remains unknown. We developed a multivariate survival model (generalized additive model) to estimate hazard risk of body surface area index (BSAi) for 3-year graft survival using data derived from the national registry database between 2005 and 2010. BSAi was calculated by BSA of donor divided by BSA of recipient. 24 509 patients were included in the analysis. Small-for-size (SFS) grafts with BSAi less than 0.78 had a significant impact on graft dysfunction with progressive increase of hazard risk toward the lowest end and a higher incidence of primary graft nonfunction and vascular thrombosis. Large-for-size (LFS) grafts with BSAi greater than 1.24 had a significant impact on graft dysfunction with progressive increase of hazard risk toward the largest end. Our findings suggest that donor grafts with BSAi < 0.78 could be considered 'SFS' and donor grafts with BSAi > 1.24 could be considered 'LFS', with both extremes resulting in decreased graft survival. Therefore, BSAi > 0.78 and <1.24 appears to be a safe range to avoid adverse outcome associated with size mismatch.

Original languageEnglish
Pages (from-to)724-733
Number of pages10
JournalTransplant International
Volume26
Issue number7
DOIs
StatePublished - Jul 1 2013

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Body Surface Area
Liver Transplantation
Transplants
Tissue Donors
Graft Survival
Blood Vessels
Registries
Thrombosis
Databases
Survival
Liver
Incidence

Keywords

  • complication
  • graft survival
  • hazard risk
  • liver transplant
  • postreperfusion syndrome

ASJC Scopus subject areas

  • Transplantation

Cite this

Determination of the safe range of graft size mismatch using body surface area index in deceased liver transplantation. / Fukazawa, Kyota; Yamada, Yoshitsugu; Nishida, Seigo; Hibi, Taizo; Arheart, Kristopher; Pretto, Ernesto.

In: Transplant International, Vol. 26, No. 7, 01.07.2013, p. 724-733.

Research output: Contribution to journalArticle

Fukazawa, Kyota ; Yamada, Yoshitsugu ; Nishida, Seigo ; Hibi, Taizo ; Arheart, Kristopher ; Pretto, Ernesto. / Determination of the safe range of graft size mismatch using body surface area index in deceased liver transplantation. In: Transplant International. 2013 ; Vol. 26, No. 7. pp. 724-733.
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