*Purpose: It is important to determine the optimal volume of liver graft in living donor liver transplantation(LDLT) for avoiding small-for-size graft syndrome(SFSS) A formula of the recommended graft volume,derived from MELD score and standard liver volume was previously reported (Liver Transpl 22 599-606 2016). The aim of this study was to validate the formula in adult LDLT in our new cohort in a different institute.

*Methods: A total of 40 consecutive recipients of adult LDLT between 2003 to 2016 in our hospital were included in this study.According to recommended graft volume (High/Low) and graft type (Right/Left),patients were classified into 4 groups;(Left-Low(LL):n=6),Left-High(LH):n=4),Right-Low(RL):n=4),and Right-High(RH):n=26).Incidence of early graft dysfunction (EAD) and intractable ascites were compared in four groups.

*Results: Median age of recipient was 52.5 and number of male was 18 patients(45%). Primary diseases consisted of liver cirrhosis with hepatocellular carcinoma(n=8), , primary biliary cirrhosis(n=7), fulminant hepatitis(n=7),alcoholic cirrhosis(n=5), hepatitis C virus (HCV) liver cirrhosis (n=4),NASH(n=4),HBV liver cirrhosis (n=4), primary sclerosing cholangitis(n=2). Small for size associated graft loss was not observed in our cohort. EAD were occurred in 9 patients(LL(n=1,16.7%),LH(n=1,16.7%),RL(n=1,16.7%),RH(n=6,23.1%) and Intractable ascites were occurred in 10 patients (LL(n=3,50%),LH(n=1,16.7%),RL(n=1,16.7%),RH(n=5,19.2%). Postoperative intractable ascites tended to occur more frequently in LL, suggesting the probability that graft selection based on the recommended volume could avoid the risk of SFSS.

*Conclusions: The graft volume formula avoiding SFSS was validated in a different cohort.

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