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Aim: To evaluate the safety to donors of living-donor liver transplantation. Methods: This study included 300 consecutive living liver tissue donors who underwent operations at our center from July 2002 to December 2012. We evaluated the safety of donors with regard to three aspects complications were recorded prospectively and stratified by grade according to Clavien’s classification, and the data were compared in two stages (the first 5 years’ experience (pre-January 2008) and the latter 5 years’ experience (post-January 2008); laboratory tests such as liver function and blood biochemistry were performed; and the health-related quality of life was evaluated. Results: There was no donor mortality at our center, and the overall morbidity rate was 25.3%. Most of the complications of living donors were either grade I or II. There were significantly fewer complications in the latter period of our study than in the initial period (19.9% vs 32.6%, P<0.001), and biliary complications were the most common complications, with an incidence of 9%. All of the liver dysfunction was temporary; however, the post-operative suppression of platelet count lasted for years. Although within the normal range, eight years after operation, 22 donors showed lower platelet levels (189×109/L) compared with the pre-operative levels (267×109/L) (P<0.05). A total of 98.4% of donors had returned to their previous levels of social activity and work, and 99.2% of donors would donate again if it was required and feasible. With the exception of two donors who experienced grade III complications (whose recipients died) and a few cases of abdominal discomfort, fatigue, chronic pain and scar itching, none of the living donors were affected by physical problems. Conclusion: With careful donor selection and specialized patient care, low morbidity rates and satisfactory long-term recovery can be achieved after hepatectomy for living-donor liver transplantation. [ABSTRACT FROM AUTHOR]

Background: Few studies have reported the clinical characteristics and outcomes of young adult patients diagnosed with hepatocellular carcinoma (HCC). This study aimed to formulate a nomogram to predict the prognosis of young adult HCC patients. Methods: Young adult patients diagnosed with HCC from 2004 to 2015 were screened from the Surveillance, Epidemiology, and End Results (SEER) database. Based on the multivariate analysis results, a nomogram was constructed. The concordance index (c-index) and calibration were used to assess the predictive performance of the nomogram. The clinical benefit was measured by using decision curve analysis (DCA). Results: The mean follow-up time of the patients was 25.0±34.0 months. Gender, race, AFP level, Edmondson–Steiner classification, treatment and TNM stage were selected as independent prognostic factors and integrated into the nomogram. The c-indexes of the two sets were 0.786 and 0.775, respectively. The calibration curves showed good agreement between the nomogram-predicted probability and the actual observations. Furthermore, the DCA indicated that the nomogram had positive net benefits compared with the conventional staging system. Conclusions: The nomogram could accurately predict the prognosis of young adult HCC patients. [ABSTRACT FROM AUTHOR]

Aims:To evaluate the impact of small-for-size grafts (SFSG) in adult-to-adult living donor liver transplantation (AALDLT) on outcomes of recipients with different model for end-stage liver disease (MELD) score in a single liver transplant center. Materials and Methods:Clinical data of 118 patients underwent right-lobe AALDLT from January 2004 to December 2011 were retrospectively analyzed, Patients were divided into Group L (MELD score≤25) and Group H (MELD score > 25) according to MELD score. The patients were further stratified into Group LS (MELD score≤25, GBWR<0.8%), Group LN (MELD score≤25, GBWR≥0.8%), Group HS (MELD score > 25, GBWR<0.8%), and Group HN (MELD score > 25, GBWR≥0.8%) to investigate the impact of graft size on recipients’ complications and outcomes. Pre-operative characteristics, post-operative complications graded by the Clavien score and patient survival were analyzed. Results:MELD scores between the two groups were significant different (12.4±4.9 vs 34.5±7.5, P=0.026). There was no significant difference in preoperative demographic data as well as postoperative liver function. Complication rate, length of ICU and hospital stay, graft loss, and mortality were similar in both groups. The 1- and 3- year survival were similar between group H and group L. When recipients were further stratified into group LS, LN, HS, and HN, no significant difference was found among groups in 1- and 3- year survival rate. In multivariate analysis, HCC was not a predictor for long term survival. Conclusion:Our single institution experience demonstrates that it is safe to use SFSGs in high pre-MELD score recipients with the improvement of intensive care and the selection of listing criteria. [ABSTRACT FROM AUTHOR]