{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T04:18:07Z","timestamp":1751516287131,"version":"3.41.0"},"reference-count":27,"publisher":"International College of Surgeons","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:p>The relationship between postoperative percentage fall of platelet (PLT) counts and graft dysfunction after living donor liver transplantation (LDLT) in recipients with small-for-size (SFS) graft has not been fully evaluated. We retrospectively studied 50 adult-to-adult LDLT recipients with a graft-to-recipient weight ratio of &lt;0.8% between 1999 and 2011. Graft dysfunction was defined as the presence of hyperbilirubinemia, coagulopathy, or ascites on 3 consecutive days during the first postoperative week. Each clinical sign of dysfunction was assigned 1 point. Postoperative percentage fall in PLT counts, graft dysfunction score, and postoperative complications according to the Clavien-Dindo classification were investigated. Overall, 31 patients (62%) exhibited a PLT count fall of more than 50%, and 19 (38%) patients exhibited a PLT count fall of less than 50% at postoperative day (POD) 3. Receiver operating characteristic curve analysis indicated that at POD 3, the cutoff value of PLT count fall was 56% for a graft dysfunction score of 2 or 3 (sensitivity, 70%; specificity, 63.3%). Fourteen of 20 patients (70%) with a dysfunction score of 2 or 3 and 11 of 30 patients (37%) with a dysfunction score of 0 or 1 showed a fall in PLT count &gt;56% at POD 3 (<jats:italic>P<\/jats:italic> = 0.021). Grade 2 to 5 complications were more observed in patients with a dysfunction score of 2 or 3 than in patients with a dysfunction score of 0 or 1 (<jats:italic>P<\/jats:italic> &lt; 0.001). The fall of PLT count at POD 3 &gt;56% is an ominous sign that can predict the graft dysfunction after LDLT in recipients with SFS graft.<\/jats:p>","DOI":"10.9738\/intsurg-d-14-00016.1","type":"journal-article","created":{"date-parts":[[2015,3,18]],"date-time":"2015-03-18T22:39:23Z","timestamp":1426718363000},"page":"524-530","source":"Crossref","is-referenced-by-count":3,"title":["Dysfunction in Patients With Small-for-Size Grafts After Living Donor Liver Transplantation"],"prefix":"10.9738","volume":"100","author":[{"given":"Shozo","family":"Mori","sequence":"first","affiliation":[{"name":"Department of Surgery, Seoul National University College of Medicine, Seoul, Korea"},{"name":"Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min-Su","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyeyoung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youngrok","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geun","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nam-Joon","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kwang-Woong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyung-Suk","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4721","reference":[{"issue":"5","key":"i0020-8868-100-3-524-b01","series-title":"Transplant Proc","first-page":"1497","article-title":"An increase in deceased donor incidence alleviated the need for urgent adult living donor liver transplantation in a Korean high-volume center","volume":"42","author":"Hwang\n              S,","year":"2010","unstructured":"Hwang\n              S, \n            \n              Lee\n              SG, \n            \n              Ahn\n              CS, \n            \n              Kim\n              KH, \n            \n              Moon\n              DB, \n            \n              Ha\n              TY\n            \n            et al\n          . An increase in deceased donor incidence alleviated the need for urgent adult living donor liver transplantation in a Korean high-volume center. Transplant Proc2010;42(5):1497\u20131501"},{"issue":"2","key":"i0020-8868-100-3-524-b02","series-title":"Transplantation","first-page":"321","article-title":"Impact of graft size mismatching on graft prognosis in liver transplantation from living donors","volume":"67","author":"Kiuchi\n              T,","year":"1999","unstructured":"Kiuchi\n              T, \n            \n              Kasahara\n              M, \n            \n              Uryuhara\n              K, \n            \n              Inomata\n              Y, \n            \n              Uemoto\n              S, \n            \n              Asonuma\n              K\n            \n            et al\n          . Impact of graft size mismatching on graft prognosis in liver transplantation from living donors. 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Transplantation2000;69(1):70\u201375"},{"issue":"8","key":"i0020-8868-100-3-524-b06","series-title":"Liver Transpl","first-page":"1159","article-title":"An artificial vascular graft is a useful interpositional material for drainage of the right anterior section in living donor liver transplantation","volume":"13","author":"Yi\n              NJ,","year":"2007","unstructured":"Yi\n              NJ, \n            \n              Suh\n              KS, \n            \n              Lee\n              HW, \n            \n              Cho\n              EH, \n            \n              Shin\n              WY, \n            \n              Cho\n              JY\n            \n            et al\n          . An artificial vascular graft is a useful interpositional material for drainage of the right anterior section in living donor liver transplantation. 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Liver Transpl2002;8(10):910\u2013915"},{"issue":"11","key":"i0020-8868-100-3-524-b09","series-title":"Am J Transplant","first-page":"2605","article-title":"Small-for-size syndrome after partial liver transplantation: definition, mechanisms of disease and clinical implications","volume":"5","author":"Dahm\n              F,","year":"2005","unstructured":"Dahm\n              F, \n            \n              Georgiev\n              P, \n            \n              Clavien\n              PA. \n          \n          Small-for-size syndrome after partial liver transplantation: definition, mechanisms of disease and clinical implications. 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World J Surg2008;32(8):1722\u20131730"},{"issue":"7","key":"i0020-8868-100-3-524-b11","series-title":"Liver Transpl","first-page":"923","article-title":"Platelets in liver transplantation: friend or foe?","volume":"14","author":"Pereboom\n              IT,","year":"2008","unstructured":"Pereboom\n              IT, \n            \n              Lisman\n              T, \n            \n              Porte\n              RJ. \n          \n          Platelets in liver transplantation: friend or foe?\n          Liver Transpl\n          2008;14(7):923\u2013931"},{"issue":"5","key":"i0020-8868-100-3-524-b12","series-title":"Gut","first-page":"754","article-title":"Thrombopoietin concentrations are low in patients with cirrhosis and thrombocytopenia and are restored after orthotopic liver transplantation","volume":"44","author":"Goulis\n              J,","year":"1999","unstructured":"Goulis\n              J, \n            \n              Chau\n              TN, \n            \n              Jordan\n              S, \n            \n              Mehta\n              AB, \n            \n              Watkinson\n              A, \n            \n              Rolles\n              K\n            \n            et al\n          . 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World J Gastroenterol2010;16(40):5011\u20135015"},{"issue":"36","key":"i0020-8868-100-3-524-b18","series-title":"World J Gastroenterol","first-page":"4556","article-title":"Early graft dysfunction following adult-to-adult living-related liver transplantation: predictive factors and outcomes","volume":"15","author":"Gruttadauria\n              S,","year":"2009","unstructured":"Gruttadauria\n              S, \n            \n              di Francesco\n              F, \n            \n              Vizzini\n              GB, \n            \n              Luca\n              A, \n            \n              Spada\n              M, \n            \n              Cintorino\n              D\n            \n            et al\n          . Early graft dysfunction following adult-to-adult living-related liver transplantation: predictive factors and outcomes. World J Gastroenterol2009;15(36):4556\u20134560"},{"issue":"3","key":"i0020-8868-100-3-524-b19","series-title":"Liver Transpl","first-page":"364","article-title":"Portal hyperperfusion: mechanism of injury and stimulus for regeneration in porcine small-for-size transplantation","volume":"16","author":"Fondevila\n              C,","year":"2010","unstructured":"Fondevila\n              C, \n            \n              Hessheimer\n              AJ, \n            \n              Taura\n              P, \n            \n              Sanchez\n              O, \n            \n              Calatayud\n              D, \n            \n              de Riva\n              N\n            \n            et al\n          . Portal hyperperfusion: mechanism of injury and stimulus for regeneration in porcine small-for-size transplantation. 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Transplantation2008;86(5):673\u2013680"},{"issue":"9","key":"i0020-8868-100-3-524-b23","series-title":"Transpl Int","first-page":"833","article-title":"The beneficial role of simultaneous splenectomy in living donor liver transplantation in patients with small-for-size graft","volume":"21","author":"Yoshizumi\n              T,","year":"2008","unstructured":"Yoshizumi\n              T, \n            \n              Taketomi\n              A, \n            \n              Soejima\n              Y, \n            \n              Ikegami\n              T, \n            \n              Uchiyama\n              H, \n            \n              Kayashima\n              H\n            \n            et al\n          . The beneficial role of simultaneous splenectomy in living donor liver transplantation in patients with small-for-size graft. Transpl Int2008;21(9):833\u2013842"},{"issue":"10","key":"i0020-8868-100-3-524-b24","series-title":"Liver Transpl","first-page":"1455","article-title":"Clinical characteristics of thrombotic microangiopathy following ABO incompatible living donor liver transplantation","volume":"13","author":"Miyata\n              R,","year":"2007","unstructured":"Miyata\n              R, \n            \n              Shimazu\n              M, \n            \n              Tanabe\n              M, \n            \n              Kawachi\n              S, \n            \n              Hoshino\n              K, \n            \n              Wakabayashi\n              G\n            \n            et al\n          . Clinical characteristics of thrombotic microangiopathy following ABO incompatible living donor liver transplantation. Liver Transpl2007;13(10):1455\u20131462"},{"issue":"14","key":"i0020-8868-100-3-524-b25","series-title":"World J Gastroenterol","first-page":"1848","article-title":"Thrombotic microangiopathy-like disorder after living-donor liver transplantation: a single center experience in Japan","volume":"17","author":"Hori\n              T,","year":"2011","unstructured":"Hori\n              T, \n            \n              Kaido\n              T, \n            \n              Oike\n              F, \n            \n              Ogura\n              Y, \n            \n              Ogawa\n              K, \n            \n              Yonekawa\n              Y\n            \n            et al\n          . Thrombotic microangiopathy-like disorder after living-donor liver transplantation: a single center experience in Japan. World J Gastroenterol2011;17(14):1848\u20131857"},{"issue":"1","key":"i0020-8868-100-3-524-b26","series-title":"Int J Hematol","first-page":"20","article-title":"Pivotal role of ADAMTS13 function in liver diseases","volume":"91","author":"Uemura\n              M,","year":"2010","unstructured":"Uemura\n              M, \n            \n              Fujimura\n              Y, \n            \n              Ko\n              S, \n            \n              Matsumoto\n              M, \n            \n              Nakajima\n              Y, \n            \n              Fukui\n              H\n            \n            et al\n          . Pivotal role of ADAMTS13 function in liver diseases. Int J Hematol2010;91(1):20\u201329"},{"issue":"5","key":"i0020-8868-100-3-524-b27","series-title":"Liver Transpl","first-page":"859","article-title":"Plasma ADAMTS13 activity may predict early adverse events in living donor liver transplantation: observations in 3 cases","volume":"12","author":"Ko\n              S,","year":"2006","unstructured":"Ko\n              S, \n            \n              Okano\n              E, \n            \n              Kanehiro\n              H, \n            \n              Matsumoto\n              M, \n            \n              Ishizashi\n              H, \n            \n              Uemura\n              M\n            \n            et al\n          . Plasma ADAMTS13 activity may predict early adverse events in living donor liver transplantation: observations in 3 cases. 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