Determining the Critical Graft-to-recipient Weight Ratio Threshold for Safety in Full-right/Full-left Split Liver Transplantation: A Multicentric Cohort Study - PubMed

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Study focuses on determining the critical graft-to-recipient weight ratio (GRWR) threshold for safety in full-right/full-left split liver transplantation (FR/FLSLT).
Multicentric retrospective study included 132 FR/FLSLT recipients from five Chinese centers (2016-2024).
Overall 3-year recipient and graft survival rates were 84.1% and 81.8%, respectively.
Recipients with GRWR ≤ 1.15 had significantly lower 3-year survival rates compared to GRWR > 1.15 (58.1% vs. 91.7% for recipient survival; 55.3% vs. 89.8% for graft survival).
Independent mortality risk factors identified: recipient age > 52 and MELD score > 15.
In patients without risk factors, no mortality or graft-loss events observed in GRWR ≤ 1.15 group, but sample size was small (n=3).
With ≥1 risk factors, GRWR ≤ 1.15 significantly increased mortality (HR 8.81) and graft loss (HR 7.50).
FR/FLSLT with GRWR > 1.15 demonstrated favorable outcomes.
GRWR ≤ 1.15 grafts may be considered for recipients without risk factors (age ≤ 52, MELD score ≤ 15), but requires further validation.

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