Study of donor-recipient liver size match for transplantation.

Abstract

This animal experiment investigated the donor-recipient liver size match for safe liver transplantation. In spite of refinements in surgical techniques in reduced liver transplantation, the liver size disparity remains one of the most common complications in pediatric patients. Optimal size matching remains unknown. The experiment compared eight groups of liver-transplanted rats with designated ratios of donor and recipient liver weights. Donor livers harvested from rats weighing 420-520 g were reduced to the designated size by liver lobectomy and implanted in rats weighing 170-240 g. Bile secretion and serum aspartate aminotransferase (AST) activities in groups 2, 4, and 6 were studied after surgery. Stepwise increase of the ratio of donor and recipient liver weights from 1.04:1 in group 4 to 1.26:1 in group 3, 1.56:1 in group 2, and 2.04:1 in group 1 caused stepwise decrease of survival rates from 83.3% to 66.7%, 16.7%, and 0%, respectively. Stepwise decrease of the ratio from 1.04:1 in group 4 to 0.79:1 in group 5, 0.53:1 in group 6, 0.35:1 in group 7, and 0.24:1 in group 8 also caused stepwise reduction of survival rates from 83.3% to 66.7%, 50%, 0%, and 0% in each group. The range of ratios of donor and recipient liver weights for successful rat liver transplantation is from 0.53:1 to 1.26:1. Increase and decrease of ratios of donor-recipient liver weights from equal size do not increase the recipient survival rates. Recipients of reduced donor liver weights tend to have a higher survival rate than recipients of increased donor liver weights.