The liver transplant procedure known as adult-to-adult living donor liver transplantation (LDLT) is noteworthy. The right liver graft (RLG) is preferred by many facilities over the left liver graft (LLG) due to the recipients’ improved recovery. For a study, researchers used LLGs and RLGs to compare the results of donors and recipients between LDLT.

The research cohort included 93 participants in the RLG group and 25 individuals in the LLG group. When both hemiliver grafts satisfied the requirements for selection, an LLG was recommended. For portal modulation, intraoperative splenic artery ligation was carried out when portal flow (≥300 ml/min/100gLW) and hepatic venous pressure gradient (≥10 mmHg) were elevated. When small-for-size syndrome (SFSS) was strongly suspected after surgery, somatostatin was given.

In comparison to the RLG group, the LLG group had a decreased graft-to-recipient weight ratio. In donors, there were no serious complications above Clavien-Dindo grade IIIA. Regarding recipient outcomes, 4 (16.0%) patients in the LLG group and 3 (3.2%) patients in the RLG group had SFSS (P = 0.036). The LLG group had more splenic artery ligations (5 [20.0%] vs. 12 [12.9%], P = 0.035) than the RLG group, and 5 patients received intravenous continuous somatostatin for 7 (5–12) days. Hospital mortality linked to SFSS didn’t happen. The results in short- and long-term did not significantly differ across the groups.

The study showed that donors and recipients in the LLG and RLG groups had similar results, despite an increased risk of SFSS that requires extensive training to prevent serious complications and graft loss. With portal flow modification techniques, they anticipated LLG would be employed more frequently in adult-to-adult LDLT to prevent deadly SFSS.