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Updated: Apr 29, 2026

Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure
Published on: September 13, 2014
Section 7. A new therapeutic strategy on portal flow modulation that increases donor safety with good recipient
Toshimi Kaido1, Kohei Ogawa, Yasuhiro Fujimoto
11 Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. 2 Department of Transplant Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan. 3 Address correspondence to: Toshimi Kaido, M.D., Ph.D., Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
Abstract:
The goal of this study was to examine whether the lower limit of the graft-to-recipient weight ratio (GRWR) can be safely reduced to make better use of the left lobe graft in adult-to-adult living donor liver transplantation in combination with portal pressure control. Beginning December 2007, the acceptable limit for GRWR was lowered to ≥0.7% and by April 2009, it was further lowered to ≥0.6%. A portal pressure control program targeting a final portal pressure <15 mm Hg was also introduced. The donor complication rate decreased from 13.8% to 9.3%. The overall survival of recipients with GRWR <0.8% did not differ from recipients with a GRWR ≥0.8%. In conclusion, the lower limit of the GRWR can be safely reduced to 0.6% using a left lobe graft in adult-to-adult living donor liver transplantation in combination with portal pressure control.
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