Assessment of Graft Selection Criteria in Living-Donor Liver Transplantation: The Jikei Experience

Abstract

In living-donor liver transplantation, graft selection is especially important for the safety of the live donor and an acceptable outcome for the recipient. The essential medical requirements for living liver donation at Jikei University Hospital are as follows: an adult aged 65 years or younger, in good general condition, with partial liver volume of more than 35% of the standard liver volume (SLV) for the recipient, and without severe liver steatosis. Based on our criteria, we performed 13 living-donor liver transplantations between 2007 and 2013, including 1 retransplantation. Three cases were outside our standard donor criteria, including age (18 and 66 years) and 33% graft volume (GV) to SLV ratio for the recipient on preoperative volumetry using computed tomography. In 2 cases, the actual GV to SLV ratio at transplantation was less than 35%. Median postoperative hospital stay was 11 days for the donors, and 29 days for the recipients. All donors returned to their preoperative status, and all recipients were discharged in good condition. Our medical requirements for living liver donation seem to be acceptable because of the good outcome.

Pulse oximetry-based capillary refilling evaluation predicts postoperative outcomes in liver transplantation: a prospective observational cohort study

“…This may explain the correlation between the length of ICU stay and the amount of ascites present. Although management regarding ICU stay may differ in each country, several Japanese studies reported similar lengths of ICU and hospital stays to this study [39,40]. It should be noted that other treatments, such as colloid and pressor administration, nutritional support, and antimicrobial agents against infection, should be conducted properly, in addition to a large of fluid resuscitation for perioperative management in liver transplantation.…”