14 January 2025 : Original article
Living Donor Liver Transplantation with Small Left Lobe Grafts: Prospective Validation of Utility of Splenectomy in Selected Recipients
Hajime Matsushima1ABCDEF*, Akihiko Soyama
1BCD, Takanobu Hara 1BCD, Takashi Hamada 1BCD, Yuta Kawaguchi1BCD, Kazushige Migita1BCD, Ayaka Satoh1BCD, Yamashita Mampei 1BCD, Hajime Imamura 1BCD, Ayaka Kinoshita1BCD, Tomohiko Adachi1BCD, Susumu Eguchi1BCD
DOI: 10.12659/AOT.946374
Ann Transplant 2025; 30:e946374
Table 1 Patient characteristics according to era.
| Total (n=173) | Era 1 (n=100) | Era 2 (n=58) | Era 3 (n=15) | P | |
|---|---|---|---|---|---|
| 1.2005–12.2014 | 1.2015–3.2021 | 4.2021–1.2024 | |||
| Recipient age, y | 57 (18–72) | 57 (24–72) | 58 (18–70) | 52 (37–68) | 0.175 |
| Sex, female | 94 (54.3%) | 52 (52.0%) | 34 (58.6%) | 8 (53.3%) | 0.721 |
| Body mass index | 22.9 (14.2–37.0) | 23.5 (16.2–37.0) | 22.5 (16.2–34.3) | 21.8 (14.2–30.1) | 0.484 |
| Diagnosis | |||||
| Hepatocellular carcinoma | 61 (35.3%) | 41 (41.0%) | 19 (32.8%) | 1 (6.7%) | 0.031 |
| Hepatitis B | 22 (12.7%) | 17 (17.0%) | 4 (6.9%) | 1 (6.7%) | 0.141 |
| Hepatitis C | 52 (30.1%) | 41 (41.0%) | 11 (19.0%) | 0 (0%) | <0.001 |
| PBC, PSC, AIH | 33 (19.1%) | 18 (18.0%) | 13 (22.4%) | 2 (13.3%) | 0.666 |
| Alcohol-related cirrhosis | 33 (19.1%) | 11 (11.0%) | 16 (27.6%) | 6 (40.0%) | 0.004 |
| MASH | 23 (13.3%) | 6 (6.0%) | 13 (22.4%) | 4 (26.7%) | 0.004 |
| MELD score | 16 (5–47) | 15 (7–47) | 17 (5–39) | 17 (11–35) | 0.970 |
| Child-Pugh grade C | 111 (64.2%) | 61 (61.0%) | 38 (65.5%) | 12 (80.0%) | 0.347 |
| Pretransplant medical condition, ICU | 16 (9.2%) | 5 (5.0%) | 8 (13.8%) | 3 (20.0%) | 0.060 |
| Portal vein thrombosis at the time of transplant | 19 (11.0%) | 9 (9.0%) | 7 (12.1%) | 3 (20.0%) | 0.423 |
| Comorbidity | |||||
| Hypertension | 28 (16.3%) | 13 (13.0%) | 12 (20.7%) | 3 (21.4%) | 0.389 |
| Diabetes mellitus | 51 (29.5%) | 27 (27.0%) | 20 (34.5%) | 4 (26.7%) | 0.591 |
| Donor age, y | 35 (18–65) | 35 (19–65) | 34 (18–63) | 40 (23–60) | 0.191 |
| ABO incompatibility | 37 (21.4%) | 21 (21.0%) | 9 (15.5%) | 7 (46.7%) | 0.032 |
| GRWR, % | 0.675 (0.329–1.287) | 0.650 (0.329–1.287) | 0.714 (0.440–1.204) | 0.650 (0.465–1.105) | 0.186 |
| Operation time, h | 13.3 (6.8–29.0) | 13.5 (6.8–19.3) | 12.4 (8.4–29.0) | 13.9 (11.5–16.9) | 0.008 |
| Splenectomy | 88 (50.9%) | 57 (57.0%) | 22 (37.9%) | 9 (60.0%) | 0.053 |
| Blood loss, mL | 6830 (980–52000) | 6950 (980–52000) | 5958 (1754–23347) | 6891 (1606–21861) | 0.767 |
| Warm ischemia time, min | 40 (26–71) | 41 (26–70) | 39 (26–71) | 44 (26–64) | 0.194 |
| Cold ischemia time, min | 92 (30–370) | 108 (49–370) | 60 (30–124) | 69 (60–90) | <0.001 |