Effects of graft and recipient weight ratio on the prognosis after living-donor liver transplantation for children with biliary atresia

Objective To explore the effects of graft and recipient weight ratio (GRWR) on initial graft function and prognosis in pediatric living donor liver transplant children with biliary atresia (BA). Methods The clinical data of 201 pediatric living-donor liver transplant BA recipients at Central Municipal Hospital from February 2013 to April 2015 were retrospectively reviewed. And 18 recipients with GRWR <2.0% served as low-GRWR group while 160 recipients with GRWR≥2.0% and GRWR<4.0% served as normal-GRWR group. Twenty-three recipients with GRWR ≥4.0% served as high-GRWR group. The clinical data were compared among three groups and the association between GRWR and initial graft poor function after living-donor liver transplantation was evaluated by Logistic regression analysis. Furthermore, 1/12/24-month cumulative survival rates were analyzed after liver transplantation. Results Logistic regression analysis revealed that GRWR<2% had a positive connection with initial poor graft function (OR=0.143, confidence interval=0.022-0.947). The cumulative surival rates at 1/12/24 months was 88.89%, 83.33%, 77.78% in low-GRWR group, 97.50%, 96.25%, 96.25% in normal-GRWR group and 95.65% in high-GRWR group. The cumulative survival rates were significantly lower in low-GRWR group than those in other groups (P<0.05%). Conclusions GRWR is a significant prognostic factor for pediatric living-donor liver transplantation. And GRWR<2% is a risk factor for initial poor graft function and 2-year mortality rate after liver transplant. Key words: Liver transplantation; Biliary atresia; Graft and recipient weight ratio; Prognsis