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Updated: Jun 8, 2026
Successful Orthotopic Liver Transplantation in Mice Utilizing Microcomputed Tomography Angiography
Published on: September 22, 2023
Body surface area index predicts outcome in orthotopic liver transplantation
Kyota Fukazawa1, Seigo Nishida, Alex Volsky
1Division of Solid Organ Transplantation, Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami, Leonard Miller School of Medicine, 1611 NW 12th Avenue, D318, Miami, FL 33136, USA. kfukazawa@med.miami.edu
Background/Purpose:
In living donor liver transplantation (LDLT), matching of liver volume between donor and recipient is critical to the success of the procedure; mismatch can result in 'small- or large-for-size syndrome'. In orthotopic liver transplantation (OLT), matching criteria are less stringent and non-uniform. We sought to determine whether a new parameter, the ratio of donor to recipient body surface area (BSAi), is predictive of size mismatch and/or post-transplant morbidity or mortality.
Methods:
We reviewed data on 1228 OLT recipients and stratified this data according to three categories: small-for-size (BSAi <0.6), control (BSAi = 0.6-1.4), and large-for-size (BSAi >1.4) donors.
Results:
We found that: (1) matching of grafts at the upper and lower extremes of BSAi had significantly reduced graft survival; (2) matches with lower BSAi sustained a less severe form of intraoperative post-reperfusion syndrome, and the incidence of hepatic artery thrombosis was high postoperatively in these grafts; (3) BSAi and donor age correlated well with the severity of intraoperative post-reperfusion hypotension; and (4) small-for-size (BSAi <0.6) and large-for-size (BSAi >1.4) grafts, as well as preoperative total bilirubin, were significant risk factors for decreased graft survival.
Conclusion:
We conclude that the BSAi can predict clinically significant size mismatch and adverse outcomes in cadaveric whole OLT.
