H S Xu1, T L Pruett, R S Jones. 1. Department of Surgery, University of Virginia Health Sciences Center, Charlottesville.
Abstract
OBJECTIVE: This animal experiment investigated the donor-recipient liver size match for safe liver transplantation. BACKGROUND: In spite of refinements in surgical techniques in reduced liver transplantation, the liver size disparity remains one of the most common complications in pediatric patients. Optimal size matching remains unknown. METHODS: The experiment compared eight groups of liver-transplanted rats with designated ratios of donor and recipient liver weights. Donor livers harvested from rats weighing 420-520 g were reduced to the designated size by liver lobectomy and implanted in rats weighing 170-240 g. Bile secretion and serum aspartate aminotransferase (AST) activities in groups 2, 4, and 6 were studied after surgery. RESULTS: Stepwise increase of the ratio of donor and recipient liver weights from 1.04:1 in group 4 to 1.26:1 in group 3, 1.56:1 in group 2, and 2.04:1 in group 1 caused stepwise decrease of survival rates from 83.3% to 66.7%, 16.7%, and 0%, respectively. Stepwise decrease of the ratio from 1.04:1 in group 4 to 0.79:1 in group 5, 0.53:1 in group 6, 0.35:1 in group 7, and 0.24:1 in group 8 also caused stepwise reduction of survival rates from 83.3% to 66.7%, 50%, 0%, and 0% in each group. CONCLUSION: The range of ratios of donor and recipient liver weights for successful rat liver transplantation is from 0.53:1 to 1.26:1. Increase and decrease of ratios of donor-recipient liver weights from equal size do not increase the recipient survival rates. Recipients of reduced donor liver weights tend to have a higher survival rate than recipients of increased donor liver weights.
OBJECTIVE: This animal experiment investigated the donor-recipient liver size match for safe liver transplantation. BACKGROUND: In spite of refinements in surgical techniques in reduced liver transplantation, the liver size disparity remains one of the most common complications in pediatric patients. Optimal size matching remains unknown. METHODS: The experiment compared eight groups of liver-transplanted rats with designated ratios of donor and recipient liver weights. Donor livers harvested from rats weighing 420-520 g were reduced to the designated size by liver lobectomy and implanted in rats weighing 170-240 g. Bile secretion and serum aspartate aminotransferase (AST) activities in groups 2, 4, and 6 were studied after surgery. RESULTS: Stepwise increase of the ratio of donor and recipient liver weights from 1.04:1 in group 4 to 1.26:1 in group 3, 1.56:1 in group 2, and 2.04:1 in group 1 caused stepwise decrease of survival rates from 83.3% to 66.7%, 16.7%, and 0%, respectively. Stepwise decrease of the ratio from 1.04:1 in group 4 to 0.79:1 in group 5, 0.53:1 in group 6, 0.35:1 in group 7, and 0.24:1 in group 8 also caused stepwise reduction of survival rates from 83.3% to 66.7%, 50%, 0%, and 0% in each group. CONCLUSION: The range of ratios of donor and recipient liver weights for successful rat liver transplantation is from 0.53:1 to 1.26:1. Increase and decrease of ratios of donor-recipient liver weights from equal size do not increase the recipient survival rates. Recipients of reduced donor liver weights tend to have a higher survival rate than recipients of increased donor liver weights.
Authors: R J Stratta; R P Wood; A N Langnas; W Marujo; R M Duckworth; L Williams; S Saito; T J Pillen; B W Shaw Journal: Transplant Proc Date: 1990-04 Impact factor: 1.066
Authors: C E Broelsch; J C Emond; J R Thistlethwaite; P F Whitington; A R Zucker; A L Baker; P F Aran; D A Rouch; J L Lichtor Journal: Ann Surg Date: 1988-10 Impact factor: 12.969
Authors: J C Emond; P F Whitington; J R Thistlethwaite; D Cherqui; E A Alonso; I S Woodle; P Vogelbach; S M Busse-Henry; A R Zucker; C E Broelsch Journal: Ann Surg Date: 1990-07 Impact factor: 12.969
Authors: C E Broelsch; P F Whitington; J C Emond; T G Heffron; J R Thistlethwaite; L Stevens; J Piper; S H Whitington; J L Lichtor Journal: Ann Surg Date: 1991-10 Impact factor: 12.969
Authors: C E Broelsch; J C Emond; J R Thistlethwaite; D A Rouch; P F Whitington; J L Lichtor Journal: Transplantation Date: 1988-03 Impact factor: 4.939