Background/aims: Liver dysfunction, also called small-for-size syndrome (SFSS), sometimes develops despite a rapid restoration of liver mass. The aim of this study was to evaluate the relationship between the graft regeneration rate and SFSS.
Methodology: We retrospectively reviewed 35 adult-to-adult living donor liver transplantation (LDLT) recipients with a graft-to-recipient weight ratio (GRWR) of <0.8% using 25 right lobe grafts and 10 left lobe grafts. The graft regeneration rate was expressed with the ratio of graft volumes measured by computed tomography at postoperative day 10 to those measured during the operation. SFSS was defined as the presence of hyperbilirubinemia, coagulopathy, and ascites after surgery.
Results: Six recipients developed SFSS. The graft regeneration rate of the SFSS (+) group was higher than the SFSS (-) group (2.12±0.39 vs. 1.70±0.29, p=0.016). In the group with a GRWR of <0.7% (n=13), 4 of 8 recipients with a graft regeneration rate of >1.86 developed SFSS, whereas none of the recipients with a graft regeneration rate of ≤1.86 developed SFSS.
Conclusions: The rapid graft regeneration is associated with SFSS after LDLT.