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Donor-Recipient Body Surface Area Mismatch and the Outcome of Liver Transplantation in the UK

Kostakis, ID; Raptis, DA; Davidson, BR; Iype, S; Nasralla, D; Imber, C; Sharma, D; ... Pollok, JM; + view all (2023) Donor-Recipient Body Surface Area Mismatch and the Outcome of Liver Transplantation in the UK. Progress in Transplantation , 33 (1) pp. 61-68. 10.1177/15269248221145035. Green open access

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Abstract

Introduction: Too small or too big liver grafts for recipient's size has detrimental effects on transplant outcomes. Research Questions: The purpose was to correlate donor-recipient body surface area (BSA) ratio or BSA index (BSAi) with recipient survival, graft survival, hepatic artery or portal vein, or vena cava thrombosis. High and low BSAi cut-off points were determined. Design: There were 11,245 adult recipients of first deceased donor whole liver-only grafts performed in the UK from January 2000 until June 2020. The transplants were grouped according to the BSAi and compared to complications, graft and recipient survival. Results: The BSAi ranged from 0.491 to 1.691 with a median of 0.988. The BSAi > 1.3 was associated with a higher rate of portal vein thrombosis within the first 3 months (5.5%). This risk was higher than size-matched transplants (OR: 2.878, 95% CI: 1.292-6.409, P = 0.01). Overall graft survival was worse in transplants with BSAi ≤ 0.85 (HR: 1.254, 95% CI: 1.051-1.497, P = 0.012) or BSAi > 1.4 (HR: 3.704, 95% CI: 2.029-6.762, P < 0.001) than those with intermediate values. The graft survival rates were reduced by 2% for cases with BSAi ≤ 0.85 but were decreased by 20% for cases with BSAi > 1.4. These findings were confirmed by bootstrap internal validation. No statistically significant differences were detected for hepatic artery thrombosis, occlusion of hepatic veins/inferior vena cava or recipient survival. Conclusions: Donor-recipient size mismatch affects the rates of portal vein thrombosis within the first 3 months and overall graft survival in deceased-donor liver transplants.

Type: Article
Title: Donor-Recipient Body Surface Area Mismatch and the Outcome of Liver Transplantation in the UK
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1177/15269248221145035
Publisher version: https://doi.org/10.1177/15269248221145035
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Surgery, Transplantation, size mismatch, body surface area, liver transplant, primary non-function, vascular complications, graft survival, recipient survival, SIZE MISMATCH, WEIGHT, FORMULA, VOLUME
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Surgical Biotechnology
URI: https://discovery.ucl.ac.uk/id/eprint/10167493
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