Korean J Transplant.  2023 Nov;37(Suppl 1):S115. 10.4285/ATW2023.F-6991.

Donor safety of remnant liver volumes of less than thirty percent in living donor liver transplantation: a systematic review and meta-analysis

• Kim SH
• Kim KH
• Cho HD

• KMID: 2551735
• DOI: http://doi.org/10.4285/ATW2023.F-6991

Abstract

Background
This meta-analysis aimed to investigate the acceptability of donor remnant liver volume (RLV) to total liver volume (TLV) ratio (RLV/TLV) being <30% as safe in living donor liver transplantations (LDLTs).
Methods
Online databases were searched from January 2000 to June 2022. Pooled odds ratios (ORs) and standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using fixed- or random-effects model.
Results
One prospective and seven retrospective studies comprising 1,935 patients (164 RLV/TLV <30% vs. 1,771 RLV/TLV 30%) were included. Overall (OR, 1.82; 95% CI, 1.24–2.67; P=0.002) and minor (OR, 1.88; 95% CI, 1.23–2.88; P=0.004) morbidities were significantly lower in the RLV/TLV 30% group than in the RLV/TLV <30% group (OR, 1.82; 95% CI, 1.24–2.67; P=0.002). No significant differences were noted in the major morbidity, biliary complications, and hepatic dysfunction. Peak levels of bilirubin (SMD, 0.50; 95% CI, 0.07–0.93; P=0.02) and international normalized ratio (SMD, 0.68; 95% CI, 0.04–1.32; P=0.04) were significantly lower in the RLV/TLV 30% group than in the RLV/TLV <30% group. No significant differences were noted in the peak alanine transferase and aspartate transaminase levels and hospital stay.
Conclusions
Considering the safety of the donor as the top priority, the eligibility of a potential liver donor in LDLT whose RLV/TLV is expected to be <30% should not be accepted.