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Dysfunction in Patients With Small-for-Size Grafts After Living Donor Liver Transplantation
- Title
- Dysfunction in Patients With Small-for-Size Grafts After Living Donor Liver Transplantation
- Authors
- Mori, Shozo; Park, Min-Su; Kim, Hyeyoung; Choi, Youngrok; Hong, Geun; Yi, Nam-Joon; Lee, Kwang-Woong; Suh, Kyung-Suk
- Ewha Authors
- 홍근
- SCOPUS Author ID
- 홍근
- Issue Date
- 2015
- Journal Title
- INTERNATIONAL SURGERY
- ISSN
- 0020-8868
- Citation
- INTERNATIONAL SURGERY vol. 100, no. 3, pp. 524 - 530
- Keywords
- Thrombocytopenia; Small-for-size graft; Portal hypertension; Small-for-size syndrome; Graft dysfunction
- Publisher
- INT COLLEGE OF SURGEONS
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- The relationship between postoperative percentage fall of platelet (PLT) counts and graft dysfunction after living donor liver transplantation (LDLT) in recipients with small-forsize (SFS) graft has not been fully evaluated. We retrospectively studied 50 adult-to-adult LDLT recipients with a graft-to-recipient weight ratio of <0.8% between 1999 and 2011. Graft dysfunction was defined as the presence of hyperbilirubinemia, coagulopathy, or ascites on 3 consecutive days during the first postoperative week. Each clinical sign of dysfunction was assigned 1 point. Postoperative percentage fall in PLT counts, graft dysfunction score, and postoperative complications according to the Clavien-Dindo classification were investigated. Overall, 31 patients (62%) exhibited a PLT count fall of more than 50%, and 19 (38%) patients exhibited a PLT count fall of less than 50% at postoperative day (POD) 3. Receiver operating characteristic curve analysis indicated that at POD 3, the cutoff value of PLTcount fall was 56% for a graft dysfunction score of 2 or 3 (sensitivity, 70%; specificity, 63.3%). Fourteen of 20 patients (70%) with a dysfunction score of 2 or 3 and 11 of 30 patients (37%) with a dysfunction score of 0 or 1 showed a fall in PLTcount >56% at POD 3 (P = 0.021). Grade 2 to 5 complications were more observed in patients with a dysfunction score of 2 or 3 than in patients with a dysfunction score of 0 or 1 (P < 0.001). The fall of PLT count at POD 3.56% is an ominous sign that can predict the graft dysfunction after LDLT in recipients with SFS graft.
- DOI
- 10.9738/INTSURG-D-14-00016.1
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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