Safety of Patients with a Graft to Body Weight Ratio Less than 0.8% in Living Donor Liver Transplantation using Right Hepatic Lobe without Middle Hepatic Vein

Background/Aims: This study aimed to evaluate the postoperative outcomes of patient with a graft with graft: to body weight ratio (GBWR) less than 0.8% after living donor liver transplantation (LDLT) using the right: hepatic lobe without middle hepatic vein (MHV). Methodology: The clinical data of patients who underwent LDLTs using the right hepatic lobe without the MHV, between March 2306 and April 2009, were retrospectively analyzed. Patients were divided into two groups according to the GBWR (group A, GBWR <0.8%; group B, GBWR >= 0.8%). Preoperative characteristics were statistically analyzed. Postoperative complications were classified by the Clavien classification. The Kaplan-Meier survival analysis with logrank test was used to compare the long-term survival of two groups. Results: The two groups were comparable. Similar incidence of serious postoperative surgical complication (grade >= 3) was observed between the two groups. The 1-, 3- and 4-year survival rates of the two groups were 81%, 64% and 57%, and 83%, 71% and 64%, respectively. No significant differences were observed. Conclusions: Small-for-size graft (GBWR <0.8%) can be safely used in adult-to-adult LDLT using right hepatic lobe without MHV.