The Product of Donor Age and Preoperative MELD, D-MELD, Predicts Surgical Outcomes After LDLT, When Using Small Graft
A. Tanemura, S. Mizuno, H. Kato, Y. Murata, N. Kuriyama, Y. Azumi, M. Kishiwada, M. Usui, H. Sakurai, S. Isaji.
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 2, 2024.« Back to 2015 American Transplant Congress