Korean J Transplant.  2023 Nov;37(Suppl 1):S294. 10.4285/ATW2023.F-9079.

Small for size syndrome in adult living donor liver transplantation based on ILTS-iLDLT-LTSI 2023 consensus definition

• Pardasani M
• Gunasekaran VK
• Rammohan A
• Shankar S
• Cherukuru R
• Palaniappan K
• Rajalingam R
• Narasimhan G
• Kaliamoorthy I
• Rela M

• KMID: 2551923
• DOI: http://doi.org/10.4285/ATW2023.F-9079

Abstract

Background
Small for size syndrome (SFSS) is a clinical syndrome caused by a partial liver graft, that is too small to sustain the metabolic demands of the recipient. This study aims to identify the presence of SFSS and analyze its outcomes in adult patients who underwent living donor liver transplantation (LDLT).
Methods
SFSS was defined and classified as per the new ILTS-iLDLT-LTSI 2023 consensus definition. All adult patients who underwent LDLT from 2013 to 2022 were included in the study. The demographic factors, intraoperative factors, and postoperative outcomes including 90-day mortality and survival were analyzed.
Results
Out of 1,528 LDLTs done during the study period, 298 patients (19.5%) developed SFSS. The incidence of grade A, B, and C SFSS were 58.4%, 39.6%, and 2%, respectively. All grades of SFSS patients had a mean graft-to-recipient weight ratio (GRWR) of >0.8 in our cohort. Sepsis and rejection were significantly higher in grade C SFSS patients. The 90-day mortality rate among the three grades were 4.02%, 15.25%, and 16.6%, respectively which was statistically significant (P=0.002). The 1-year survival was 93.68%, 84.75%, and 83.3% among the three grades, respectively.
Conclusions
To conclude, grade C patients were associated with poorer outcomes and GRWR did not predict the occurrence of SFSS in our patient cohort.