Comparison of Clinical Outcomes Using Left and Right Liver Grafts in Adult-to-adult Living-donor Liver Transplantation: A Retrospective Cohort Study Using the Korean Organ Transplantation Registry.

Autor:	Jo HS; Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea., Kim DS; Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea., Cho JY; Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Republic of Korea., Hwang S; Department of Surgery, College of Medicine University of Ulsan, Asan Medical Center, Seoul, Republic of Korea., Choi Y; Department of Surgery, Seoul National University College of Medicine Seoul National University Hospital, Seoul, Republic of Korea., Kim JM; Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea., Lee JG; Department of Surgery, The Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, Republic of Korea., You YK; Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea., Choi D; Department of Surgery, Catholic University of Daegu, Daegu, Republic of Korea., Ryu JH; Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea., Kim BW; Department of Hepato-Biliary-Pancreatic Surgery, Ajou University School of Medicine, Suwon, Republic of Korea., Nah YW; Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea., Ju MK; Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea., Kim TS; Department of Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea., Suh SW; Department of Surgery, College of Medicine, Chung-Ang University, Seoul, Republic of Korea.
Jazyk:	angličtina
Zdroj:	Transplantation [Transplantation] 2025 Jan 01; Vol. 109 (1), pp. e45-e53. Date of Electronic Publication: 2024 Sep 09.
DOI:	10.1097/TP.0000000000005200
Abstrakt:	Background: Living-donor liver transplantation has been widely performed as an alternative to the scarce liver grafts from deceased donors. More studies are reporting favorable outcomes of left liver graft (LLG). This study compared the clinical outcomes between living-donor liver transplantation using LLG and right liver graft (RLG) with similar graft-to-recipient body weight ratios. Methods: This study analyzed 4601 patients from a multicenter observational cohort using the Korean Organ Transplantation Registry between 2014 and 2021. After matching the Model for End-stage Liver Disease score and graft-to-recipient body weight ratios because of the extremely different number in each group, the LLG and RLG groups comprised 142 (25.1%) and 423 (74.9%) patients, respectively. Results: For donors, the median age was higher in the LLG group than in the RLG group (34 y [range, 16-62 y] versus 30 y [16-66 y] ; P  = 0.002). For recipients, the LLG group showed higher 90-d mortality than the RLG group (11 [7.7%] versus 9 [2.1%]; P  = 0.004). The long-term graft survival was significantly worse in the LLG group ( P  = 0.011). In multivariate Cox proportional hazards regression analysis for graft survival, LLG was not a significant risk factor (hazard ratio, 1.01 [0.54-1.87]; P  = 0.980). Otherwise, donor age (≥40 y; 2.18 y [1.35-3.52 y]; P  = 0.001) and recipients' body mass index (<18.5 kg/m 2 ; 2.98 kg/m 2 [1.52-5.84 kg/m 2 ]; P  = 0.002) were independent risk factors for graft survival. Conclusions: Although the short-term and long-term graft survival was worse in the LLG group, LLG was not an independent risk factor for graft survival in multivariate analysis. LLGs are still worth considering for selected donors and recipients regarding risk factors for graft survival. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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