Yanhu Feng1,2, Zhijian Han3, Xiang Wang4,3, Hao Chen3,5, Yumin Li6,7. 1. Department of Gastroenterology and Hepatology, Second Hospital of Lanzhou University, Lanzhou, China. docf01@163.com. 2. Key Laboratory of the Digestive System Tumors of Gansu Province, Lanzhou, China. docf01@163.com. 3. Key Laboratory of the Digestive System Tumors of Gansu Province, Lanzhou, China. 4. Department of Gastroenterology and Hepatology, Second Hospital of Lanzhou University, Lanzhou, China. 5. Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, China. 6. Key Laboratory of the Digestive System Tumors of Gansu Province, Lanzhou, China. liym@lzu.edu.cn. 7. Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, China. liym@lzu.edu.cn.
Abstract
BACKGROUND: Studies indicate that low graft-to-recipient weight ratio (GRWR) affect graft survival in adult-to-adult living donor liver transplantation. However, the potential role of GRWR in the prognosis of patients following living donor liver transplantation according to patient characteristics remains controversial. This study aimed to update the role of GRWR in patients following living donor liver transplantation. METHODS: PubMed, Embase, and Cochrane Library were comprehensively searched for studies comparing low GRWR (< 0.8%) with normal GRWR (≥ 0.8%) in the prognosis following living donor liver transplantation from inception to March 2019. The 1-, 3-, and 5-year summary survival rates, small-for-size syndrome (SFSS), perioperative mortality, biliary complications, postoperative bleeding, and acute rejection were calculated using the random-effects model. RESULTS: Eighteen studies comprising 4001 patients were included. Patients with low GRWR were associated with lower 1-year and 3-year survival rates compared to patients with normal GRWR, while no significant difference was found in the association of 5-year survival rate with low and normal GRWRs. Moreover, the risk of SFSS significantly increased in patients with low GRWR. Finally, no significant differences were observed in the association of low and normal GRWRs with the risk of perioperative mortality, biliary complications, postoperative bleeding, and acute rejection. CONCLUSION: The results of this study indicated that low GRWR was associated with poor prognosis for patients following living donor liver transplantation, especially in terms of 1- and 3-year survival rates and SFSS.
BACKGROUND: Studies indicate that low graft-to-recipient weight ratio (GRWR) affect graft survival in adult-to-adult living donor liver transplantation. However, the potential role of GRWR in the prognosis of patients following living donor liver transplantation according to patient characteristics remains controversial. This study aimed to update the role of GRWR in patients following living donor liver transplantation. METHODS: PubMed, Embase, and Cochrane Library were comprehensively searched for studies comparing low GRWR (< 0.8%) with normal GRWR (≥ 0.8%) in the prognosis following living donor liver transplantation from inception to March 2019. The 1-, 3-, and 5-year summary survival rates, small-for-size syndrome (SFSS), perioperative mortality, biliary complications, postoperative bleeding, and acute rejection were calculated using the random-effects model. RESULTS: Eighteen studies comprising 4001 patients were included. Patients with low GRWR were associated with lower 1-year and 3-year survival rates compared to patients with normal GRWR, while no significant difference was found in the association of 5-year survival rate with low and normal GRWRs. Moreover, the risk of SFSS significantly increased in patients with low GRWR. Finally, no significant differences were observed in the association of low and normal GRWRs with the risk of perioperative mortality, biliary complications, postoperative bleeding, and acute rejection. CONCLUSION: The results of this study indicated that low GRWR was associated with poor prognosis for patients following living donor liver transplantation, especially in terms of 1- and 3-year survival rates and SFSS.
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