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Impact of Graft Size Matching on the Early Post-Transplant Complications and Patients Survival in Children after Living Donor Liver Transplantations

We aimed to assess the impact of the graft-recipient weight ratio (GRWR) on early post-transplant complications and patient survival rates in children after living donor liver transplantation (LDLT). We retrospectively analyzed 321 patients who underwent LDLT from 2004 to 2019. The recipients were c...

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Autores principales: Stefanowicz, Marek, Kowalewski, Grzegorz, Szymczak, Marek, Patkowski, Waldemar, Zieniewicz, Krzysztof, Grzelak, Ireneusz, Kowalski, Adam, Ismail, Hor, Kamińska, Diana, Kaliciński, Piotr
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8307631/
https://www.ncbi.nlm.nih.gov/pubmed/34356558
http://dx.doi.org/10.3390/children8070579
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author Stefanowicz, Marek
Kowalewski, Grzegorz
Szymczak, Marek
Patkowski, Waldemar
Zieniewicz, Krzysztof
Grzelak, Ireneusz
Kowalski, Adam
Ismail, Hor
Kamińska, Diana
Kaliciński, Piotr
author_facet Stefanowicz, Marek
Kowalewski, Grzegorz
Szymczak, Marek
Patkowski, Waldemar
Zieniewicz, Krzysztof
Grzelak, Ireneusz
Kowalski, Adam
Ismail, Hor
Kamińska, Diana
Kaliciński, Piotr
author_sort Stefanowicz, Marek
collection PubMed
description We aimed to assess the impact of the graft-recipient weight ratio (GRWR) on early post-transplant complications and patient survival rates in children after living donor liver transplantation (LDLT). We retrospectively analyzed 321 patients who underwent LDLT from 2004 to 2019. The recipients were categorized into four groups: 37 patients had a GRWR ≤ 1.5% (Group A), 196 patients had a GRWR > 1.5% and ≤3.5% (Group B), 73 patients had a GRWR > 3.5% and <5% (Group C) and 15 patients had a GRWR ≥ 5% (Group D). Incidence of early surgical complications including vascular complications, biliary complications, postoperative bleedings, gastrointestinal perforations and graft loss were comparable among groups with a different GRWR. Delayed abdominal wound closure was more common in patients with a GRWR > 3.5%. Recipients with a GRWR < 5% had a significantly better prognosis concerning patients and graft survival. Using grafts with a GRWR < 5% allows us to expand the donor pool and decrease the risk of mortality while on the waiting list, when patients at the time of transplantation have less advanced liver disease. LDLT with a GRWR ≥ 5% is related to a higher risk of poor outcome, and thus should be an option for treating selected patients when the risk of a delayed transplantation is high and access to deceased donors is limited.
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spelling pubmed-83076312021-07-25 Impact of Graft Size Matching on the Early Post-Transplant Complications and Patients Survival in Children after Living Donor Liver Transplantations Stefanowicz, Marek Kowalewski, Grzegorz Szymczak, Marek Patkowski, Waldemar Zieniewicz, Krzysztof Grzelak, Ireneusz Kowalski, Adam Ismail, Hor Kamińska, Diana Kaliciński, Piotr Children (Basel) Article We aimed to assess the impact of the graft-recipient weight ratio (GRWR) on early post-transplant complications and patient survival rates in children after living donor liver transplantation (LDLT). We retrospectively analyzed 321 patients who underwent LDLT from 2004 to 2019. The recipients were categorized into four groups: 37 patients had a GRWR ≤ 1.5% (Group A), 196 patients had a GRWR > 1.5% and ≤3.5% (Group B), 73 patients had a GRWR > 3.5% and <5% (Group C) and 15 patients had a GRWR ≥ 5% (Group D). Incidence of early surgical complications including vascular complications, biliary complications, postoperative bleedings, gastrointestinal perforations and graft loss were comparable among groups with a different GRWR. Delayed abdominal wound closure was more common in patients with a GRWR > 3.5%. Recipients with a GRWR < 5% had a significantly better prognosis concerning patients and graft survival. Using grafts with a GRWR < 5% allows us to expand the donor pool and decrease the risk of mortality while on the waiting list, when patients at the time of transplantation have less advanced liver disease. LDLT with a GRWR ≥ 5% is related to a higher risk of poor outcome, and thus should be an option for treating selected patients when the risk of a delayed transplantation is high and access to deceased donors is limited. MDPI 2021-07-06 /pmc/articles/PMC8307631/ /pubmed/34356558 http://dx.doi.org/10.3390/children8070579 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Stefanowicz, Marek
Kowalewski, Grzegorz
Szymczak, Marek
Patkowski, Waldemar
Zieniewicz, Krzysztof
Grzelak, Ireneusz
Kowalski, Adam
Ismail, Hor
Kamińska, Diana
Kaliciński, Piotr
Impact of Graft Size Matching on the Early Post-Transplant Complications and Patients Survival in Children after Living Donor Liver Transplantations
title Impact of Graft Size Matching on the Early Post-Transplant Complications and Patients Survival in Children after Living Donor Liver Transplantations
title_full Impact of Graft Size Matching on the Early Post-Transplant Complications and Patients Survival in Children after Living Donor Liver Transplantations
title_fullStr Impact of Graft Size Matching on the Early Post-Transplant Complications and Patients Survival in Children after Living Donor Liver Transplantations
title_full_unstemmed Impact of Graft Size Matching on the Early Post-Transplant Complications and Patients Survival in Children after Living Donor Liver Transplantations
title_short Impact of Graft Size Matching on the Early Post-Transplant Complications and Patients Survival in Children after Living Donor Liver Transplantations
title_sort impact of graft size matching on the early post-transplant complications and patients survival in children after living donor liver transplantations
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8307631/
https://www.ncbi.nlm.nih.gov/pubmed/34356558
http://dx.doi.org/10.3390/children8070579
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