Impact of Non-middle Hepatic Vein Reconstruction on the Result of Low Graft-to-recipient Weight Ratio Living Donor Liver Transplantation

  Objective   To analyze of the minimum graft-to-recipient weight ratio (GRWR) required for living donor liver transplantation (LDLT) without middle hepatic vein branch (MHVT) reconstruction.

  Methods   We retrospectively collected the clinical data and outcomes of 303 LDLT patients over 16 years from 2001 to 2017. The minimum GRWR of non-middle hepatic vein reconstruction was analyzed by propensity score (PSM).

  Results  With PSM analysis, no significant differences were observed in postoperative complications, SFSS, inpatient time, liver function, and coagulation function, but significant differences in 1-year, 3-year and 5-year survival between MHVT reconstruction and non-reconstruction group. The patients with MHVT reconstruction had better short-term and long-term survival than those without reconstruction.

  Conclusion  For LDLT patients without HMVT reconstruction, GRWR should be greater than 0.86%; for patients with HMVT reconstruction, GRWR is acceptable between 0.5% and 0.6%.