Introduction: We compared the impact of estimating graft to recipient body weight ratio (GBWR) with actual body weight (ABW) and ideal body weight (IBW) on outcomes after LDLT.

Methods: We reviewed 520 adult-to-adult LDLT performed between April-2000 and June-2015. GBWR estimations with recipient's ABW (aGBWR) and IBW (iGBWR) were compared to identify the group at risk for small-for-size syndrome (SFSS), re-transplantation and graft loss.

Results: 50 LDLT cases with aGBWR < 0.8 were compared with 424 LDLT cases with aGBWR > 0.8. Recipients with aGBWR < 0.8 had lower graft weight (640.2 vs 896.0 p=0.0001), higher incidence of SFSS (20% vs 4.2%, p=0.0001), increased need for re-transplantation (16.0% vs 5.7%, p=0.013), but similar graft survival (90.1/83.2/80.7% vs 87.6/84.7/80.7%, p=0.48) and patient survival (92.5/85.9/83.9% vs. 93.8/90.9/90.9%, p=0.19) at 1/3/5 years.

17 LDLT cases with iGBWR < 0.8 were compared with 452 LDLT cases with iGBWR > 0.8. Recipients with iGBWR < 0.8 had lower graft weight (473.1 vs 882.4 p=0.0001), a higher incidence of SFSS (11.8% vs 5.5%, p=NS), increased risk for re-transplantation (35.3% vs 5.8%, p=0.0001), a lower graft survival (82.4/72.1/54.0% vs 90.7/84.1/81.7%, p=0.026), but similar patient survival (94.1/94.1/94.1% vs. 93.2/86.6/84.7%, p=0.41) at 1/3/5 years.

Conclusion: Graft to 'ideal' body weight ratio iGBWR < 0.8 is a novel index that may be better than standard criteria at identifying patients with a higher risk for graft loss. Both aGBWR and iGBWR should be considered prior to LDLT.

CITATION INFORMATION: Dib M, Goldaracena N, Barbas A, Marquez M, Alotaiby N, Sapisochin G, Cattral M, Lilly L, McGilvray I, Renner E, Greig P, Ghanekar A, Selzner N, Selzner M, Grant D. Impact of Ideal Body Weight vs. Actual Body Weight for the Prediction of Small for Size Syndrome and Graft Loss After Living Donor Liver Transplantation. Am J Transplant. 2016;16 (suppl 3).

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