The Product of Donor Age and Preoperative MELD, D-MELD, Predicts Surgical Outcomes After LDLT, When Using Small Graft
Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Tsu, Japan.
Meeting: 2015 American Transplant Congress
Abstract number: B149
Keywords: Age factors, Liver transplantation, Living-related liver donors
Session Information
Session Name: Poster Session B: Liver: Living Donors
Session Type: Poster Session
Date: Sunday, May 3, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Background:
Donor-recipient match is recognized as the factor well predicting recipient outcome in deceased donor liver transplantation. The aim of the present study is to evaluate how donor-recipient match affects recipient outcome in living donor liver transplantation (LDLT) using D-MELD score (donor age × recipient MELD score), paying attention to graft type.
Patient and methods:
The 119 consecutive cases, who received adult-to-adult LDLT from March 2002 to November 2014, were divided into two groups according to D-MELD score: Low-DM (n=100): D-MELD <1000, High-DM (n=19): D-MELD ≥1000. Among them, the 71 cases of right lobe LDLT were also divided into two groups according to D-MELD score: Low-DM-large (n=60), High-DM-large (n=11), and the 48 cases of left lobe LDLT (including 3 cases using posterior graft) were also divided into two groups: Low-DM-small(n=40), High-DM-small (n=8).
Results:
In the whole recipient analysis, 3-month mortality rate was significantly higher in High-DM than in Low-DM: 36.8% vs 14.0% (p=0.02). There were no differences in postoperative liver function such as total bilirubin level and the amount of ascites, and long-term patient survival did not differ between the two groups. In the recipients who received right lobe LDLT, 3-month mortality rate and long-term patient survival did not differ between the two groups: 27% in High-DM-large vs 15% in Low-DM-large in 3-month mortality, and there were no differences in postoperative liver function. In the recipients who received left lobe LDLT, 3-month mortality rate was significantly higher in High-DM-small than in Low-DM-small: 50% vs 12.5% (p=0.02). Total bilirubin levels were significantly higher in High-DM-small than in Low-DM-small on postoperative day 14: 17.4 mg/dl vs 7.9 mg/dl (p=0.007). Long-term survival rate was lower in High-DM-small than in Low-DM-small: 50% vs 74% at 3-year survival, although it did not reach statistical significance.
Conclusions:
D-MELD can predict the surgical outcomes in LDLT, especially in the cases using left lobe graft. D-MELD may help us to avoid the high risk donor-recipient match when using smaller graft like left lobe in LDLT.
To cite this abstract in AMA style:
Tanemura A, Mizuno S, Kato H, Murata Y, Kuriyama N, Azumi Y, Kishiwada M, Usui M, Sakurai H, Isaji S. The Product of Donor Age and Preoperative MELD, D-MELD, Predicts Surgical Outcomes After LDLT, When Using Small Graft [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/the-product-of-donor-age-and-preoperative-meld-d-meld-predicts-surgical-outcomes-after-ldlt-when-using-small-graft/. Accessed November 24, 2024.« Back to 2015 American Transplant Congress