Massive ascites after living donor liver transplantation with a right lobe graft larger than 0.8% of the recipient's body weight.

Shirouzu Y, Ohya Y, Suda H, Asonuma K, Inomata Y
Clin Transplant. 2010 24 (4): 520-7

PMID: 19843111 · DOI:10.1111/j.1399-0012.2009.01117.x

BACKGROUND - There are only limited data on post-transplant ascites unrelated to small-sized grafts in living donor liver transplantation (LDLT).

METHODS - The subjects were 59 adult patients who had received right lobe LDLT with a graft weight-to-recipient weight ratio (GRWR)>0.8%. Patients were divided into either Group 1 (n=14, massive ascites, defined as the production of ascitic fluid>1000 mL/d that lasted longer than 14 d after LDLT) or Group 2 (n=45, no development of massive ascites). Patients were followed for a median period of 3.0 yr (range, 0.5-7.5 yr).

RESULTS - Group 1 had both higher Model for End-Stage Liver Disease score and Child-Pugh score than Group 2. Portal venous flow volume just after reperfusion was significantly greater in Group 1 than Group 2 (307.8±268.8 vs. 176.2±75.0 mL/min/100 g graft weight, respectively; p<0.05). Post-transplant infectious complications including ascites infection developed more frequently within the first post-transplant month in Group 1. Massive ascites was significantly associated with early graft loss (p<0.05).

CONCLUSION - Post-transplant massive ascites associated with portal over-perfusion into the graft liver can develop in patients with a GRWR over 0.8%. Recipients with post-transplant massive ascites require careful management to prevent infection.

© 2009 John Wiley & Sons A/S.

MeSH Terms (19)

Adolescent Adult Aged Ascites Body Weight Female Graft Survival Humans Liver Liver Failure Liver Transplantation Living Donors Male Middle Aged Organ Size Postoperative Complications Retrospective Studies Treatment Outcome Young Adult

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