Size mismatch in liver transplantation

Kyota Fukazawa, Seigo Nishida

Research output: Contribution to journalReview articlepeer-review

19 Scopus citations


Size mismatch is an unique and inevitable but critical issue in live donor liver transplantation. Unmatched metabolic demand of recipient as well as physiologic mismatch aggravates the damage to liver graft, inevitably leading to graft failure on recipient. Also, an excessive resection of liver graft for better recipient outcome in live donor liver transplant may jeopardize the healthy donor well-being and even put donor life in danger. There is a fine balance between resected graft volume required to meet the recipient's metabolic demand and residual graft volume required for donor safety. The obvious clinical necessity of finding that balance has prompted a clinical need and promoted the improvement of knowledge and development of management strategies for size-mismatched transplants. The development of the size-matching methodology has significantly improved graft outcome and recipient survival in live donor liver transplants. On the other hand, the effect of size mismatch in cadaveric transplants has never been observed as being so pronounced. The importance of matching of the donor recipient size has been unrecognized in cadaveric liver transplant. In this review, we attempt to summarize the current most updated knowledge on the subject, particularly addressing the definition and complications of size-mismatched cadaveric liver transplant, as well as management strategies.

Original languageEnglish (US)
Pages (from-to)457-466
Number of pages10
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Issue number8
StatePublished - Aug 1 2016


  • Graft outcome
  • Graft weight-to-recipient body weight ratio
  • Large for size
  • Size mismatch
  • Small-for-size
  • Standard liver volume

ASJC Scopus subject areas

  • Hepatology
  • Surgery


Dive into the research topics of 'Size mismatch in liver transplantation'. Together they form a unique fingerprint.

Cite this