Graft Inflow Modulation in Living-Donor Liver Transplantation: Hepatic Hemodynamic Changes in Splenic Artery Ligation and Splenectomy

19 July 2022 : Original article

Che-Min Su^1ABCDEF, Tsung-Ching Chou^1ABD, Tsung-Han Yang^1ABD, Yih-Jyh Lin^1ABDEF*

DOI: 10.12659/AOT.936609

Ann Transplant 2022; 27:e936609

Background Material and Methods Results Discussion Conclusions References

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Table 1 Clinical characteristics of all recipients and donors.

VariablesModulation	Group No.	GIM group (SAL+splenectomy)	P-value
N	63	36 (17+19)	P-value
Recipient
Age, years	58 (51–62)	56 (49–63)	0.613
Sex (M), n (%)	42 (66.7)	23 (63.9)	0.779
BMI, kg/m	25.1 (23.2–29.6)	25.2 (23.5–26.5)	0.741
Hepatitis profile			0.840
HBV+/HCV+	3 (4.8)	2 (6.7)
HBV+	31 (49.2)	15 (41.7)
HCV+	13 (20.6)	8 (22.2)
Negative	16 (25.4)	11 (30.6)
Disease indication, n (%)			0.152
Acute/acute on chronic liver failure	16 (25.4)	4 (16.7)
Decompensated cirrhosis	23 (36.5)	19 (52.8)
Hepatocellular carcinoma	24 (38.1)	13 (36.1)
MELD	13 (9–30)	15 (11–23)	0.633
MELD ≥25, n (%)	18 (28.6)	8 (22.2)	0.490
ABO incompatible, n (%)	11 (17.5)	7 (19.4)	0.806
Donor
Donor age, y	31 (25–38)	31 (23–36)	0.267
Donor age ≥40, n (%)	11 (17.5)	5 (13.9)	0.642
Sex (M), n (%)	40 (63.5)	16 (44.4)	0.066
BMI, kg/m	23.5 (20.7–25.3)	22.3 (19.6–23.6)	0.046
Liver graft
Actual GRWR (%)	1.04 (0.90–1.19)	0.91 (0.77–1.11)	0.022
GRWR <0.8%, n (%)6	9 (14.3)	11 (30.6)	0.027
Graft weight, g	680 (571–812)	612 (541–703)	0.017
Graft type, n (%)			0.80
Right lobe	56 (88.9)	31 (86.1)
Left lobe	5 (7.9)	4 (11.1)
Right lobe with MHV	1 (1.6)	0
Right posterior section	1 (1.6)	1 (2.8)
SAL – splenic artery ligation; BMI – body mass index; HBV – hepatitis B virus; HCV – hepatitis C virus; MELD – model of end-stage liver disease; GRWR – graft-to-recipient weight ratio. Continuous variables are expressed as the median (IQR). Categorical variables are expressed as number of patients (percentage).

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