Improved graft survival by using three-dimensional printing of intra- abdominal cavity to prevent large-for-size syndrome in liver transplantation

Improved graft survival by using three-dimensional printing of intra- abdominal cavity to prevent large-for-size syndrome in liver transplantation | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Improved graft survival by using three-dimensional printing of intra- abdominal cavity to prevent large-for-size syndrome in liver transplantation Sunghae Park, Gyu-Seong Choi, Jongman Kim, Sanghoon Lee, Jae-Won Joh, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4157626/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 08 Jun, 2023 Read the published version in Annals of Hepato-Biliary-Pancreatic Surgery → Version 1 posted You are reading this latest preprint version Abstract Background In liver transplantation (LT), large-for-size syndrome is not common but can result in fatal outcome. To prevent such fatal outcome, we manufactured 3-D printed intra-abdominal cavity to give intuitive understanding of the sizes of the graft and patient’s abdomen in patients with small body size between July 2020 to February 2022. Methods Clinical outcomes were compared between patients using our 3-D model during LT and patients who underwent LT without 3-D model by using 1:5 ratio propensity score-matched analysis. Results After matching, total 20 patients using 3-D printed abdominal cavity model and 100 patients of control group were included in this study. There were no significant differences in 30-day postoperative complication (50.0% vs 64.0%, p = 0.356) and the incidence of large-for-size syndrome (0% vs 7%, p = 0.599). Overall survival of 3-D printed group was similar to the control group ( p = 0.665) but graft survival was significantly superior in 3-D printed group than the control group ( p = 0.034). Conclusion Since it showed better graft survival as well as low cost and short production time, our 3-D printing protocol can be a feasible option for patients with small abdominal cavity to prevent large-for-size syndrome after LT. 3-D printing liver transplantation graft survival donor selection Figures Figure 1 Figure 2 Figure 3 Figure 4 Background Liver transplantation (LT) is standard therapy for acute and chronic liver failure and has evolved rapidly due to the advancement of immunosuppressive agents and surgical techniques.[ 1 ] However, severe organ shortage remains as an unresolved issue and only limited number of LT candidates can receive liver grafts. To make sure for the success of LT, the size of the expected graft should be adequate for the recipient. When the liver graft is too small for the recipient, small-for-size syndrome can occur, and it can usually be predicted by calculating the graft-recipient-weight ratio (GRWR).[ 2 , 3 ] On the other hand, when a liver graft is too large to fit inside the abdominal cavity, large-for-size syndrome can occur.[ 2 , 4 ] Although the incidence of large-for-size syndrome is low, fatal outcome can occur due to graft compression, followed by poor oxygen supply leading to graft dysfunction.[ 2 , 5 ] Therefore, understanding the size of the recipient’s abdominal cavity in relation to graft liver volume is significant to prevent large-for-size syndrome. While the risk of large-for-size syndrome is quite low for living donor LT (LDLT) since the donor is also evaluated before transplant, deceased donors have limitation in pre-transplant evaluation and there is always a risk for the graft being too large for recipients who have small intra-abdominal cavity. Three-dimensional (3-D) printing with its potential as personalized medical tool has started to be utilized in medicine especially in maxillofacial and craniofacial surgery.[ 6 ] There also has been an effort for using 3-D printing in the field of liver surgery but mostly focused on understanding the anatomical structures.[ 7 , 8 ] In 2013, the use of 3-D printing in LT was first introduced by the literature of Zein et al. and has been continuously developed but still it is too expensive and time-consuming to be practically utilized.[ 9 ] To maximize its utility, our team managed to focus on reconstructing the LT recipients’ abdominal cavity by its actual size while minimizing the time for manufacturing. Our initial experience on utilizing our 3-D printing protocol for LT recipients with small abdominal cavity showed successful clinical outcome with short manufacturing time.[ 10 ] By the successful application of 3-D printing for preventing large-for-size syndrome in recipients with potential risk, we designed this study to analyze whether the 3-D printed abdominal cavity protocol actually improved our clinical practice by comparing the clinical outcome of patients with 3-D printing to patients without 3-D printing using propensity score (PS) matching. MATERIALs and methods Patient selection of 3-D printing of abdominal cavity The study included a total of 760 patients who underwent LT between January 2017 and March 2022. Among these patients, twenty patients had their abdominal cavity manufactured using a 3-D printed model. The selection of patients for this process was based on the operator's decision, taking into account the spatial relationship between the recipient's liver fossa and the liver graft. Patients with small-sized abdominal cavities, mostly female or pediatric recipients, were chosen. In cases of LDLT, patients with an expected graft-recipient weight ratio (GRWR) exceeding 2% or a liver graft larger than 1000cm 3 were selected for 3-D printing of the intra-abdominal cavity. For patients on the waiting list for a deceased donor match, the following criteria were used for printing a 3-D model: (1) female recipients who were not 10 cm taller than the allocated male donor, (2) male recipients who were at least 10 cm shorter than the allocated female donor, (3) matches of the same sex where the recipient was at least 10 cm shorter than the donor, and (4) individuals with a small right liver fossa, defined as an anteroposterior (AP) length of ≤ 13 cm or a lateral space from the inferior vena cava of ≤ 10 cm. Additionally, the transplant surgeon's judgment played a role in the selection process, especially when the recipient had an abdominal cavity deformity that did not fit the mentioned criteria. 3-D modeling of the recipient’s abdominal cavity The workflow for creating and applying a 3-D printed model in both living donor and deceased donor liver transplantation (LT) is depicted in Fig. 1 . The process begins with the recipient's computed tomography (CT) scan, which is used to outline the inner space of the abdominal cavity where the graft liver will be positioned. Mimics Medical 21.0 (Materialise, Leuven, Belgium) is employed for this purpose. The inner surface of the abdominal cavity, excluding the medial two-thirds of the anterior wall, is outlined with a 1 to 3 centimeter gap between slices. In the case of adult recipients, only the right half of the abdomen is outlined, whereas both the right and left halves are outlined for pediatric recipients and adults undergoing left liver transplantation. Once the outline of the intra-abdominal cavity is marked, the lines are reconstructed into a 3-D model using Cinema 4D (Maxon, Friedrichsdorf, Germany). Subsequently, the 3-D model is printed individually using Cubicreator software and Cubicon Single Plus (Cubicon, Seong nam, Republic of Korea), a fused deposition modeling type 3-D printer. After printing, each piece is assembled to create the final 3-D printed model. This model assists in the decision-making process of whether to utilize a specific liver graft or not. The application of the 3-D printed abdominal cavity model during LT decision-making is depicted in Fig. 2 . Data acquisition Baseline characteristics of the donor and recipient for both 3-D printed group and the control group were collected. In addition, data of graft, recipients’ abdominal cavity, and 3-D model were collected. Graft data included type of graft, weight, and GRWR. We measured AP and lateral length of right liver fossa, and AP length of midline of recipients to roughly estimate the abdominal cavity based on CT of recipients before LT. Data regarding 3-D printed model included amount of materials, cost and manufacturing time needed for 3-D printing. The clinical course before and after using the 3-D printed model was also collected. In addition, demographical data and clinical course of the patients who experienced large-for-size syndrome during the study period were collected. Statistical analysis To reduce the impact of selection bias, we performed a 1:5 ratio PS matching analysis with nearest neighbor method between the 3-D printed group and the control group. The control group was consisted of patients who underwent LT without using 3-D printing model during January 2017 to March 2022. The PS of each case was calculated using a multivariable logistic regression model by including variables such as sex, age, height, weight, adult or pediatric, LT from living or deceased donor, graft type, graft weight, donor sex, donor age, donor height, and donor weight. After PS matching, 20 cases in the 3-D printed group were matched to 100 cases in the control group. The outcomes between the 3-D printed group and the control group were compared, such as 30-day complication of recipients, reoperation within 30 days, large-for-size syndrome, graft failure and death of recipient. Numerical variables were compared with the Student t test or Mann-Whitney U test and expressed as mean ± standard deviation or median (interquartile range [IQR]), respectively. Categorical variables were compared with chi-square test or Fisher’s exact test. Kaplan-Meier survival curve analysis was performed to estimate the graft survival and overall survival rates after PS matching. Statistical analyses were performed using SPSS 26.0 (SPSS Inc., Chicago, IL) and R version 4.1.1 (R Foundation for Statistical Computing, Vienna, Austria). This study was approved by the Institutional Review Board (IRB No. 2022-08-101-001). Results Baseline characteristics before and after PS matching Among 760 patients who underwent LT between July 2020 to March 2022, 20 patients underwent LT using 3-D printed abdominal cavity models. Table 1 summarizes the baseline characteristics of donors and recipients between the 3-D printed group and the control group before and after PS matching. Before PS matching, there were higher proportion of female patients (30.3% vs. 75.0%, p < 0.001), pediatric patients (3.6% vs. 30.0%, p < 0.001), re-LT patients (5.6% vs. 20.0%, p = 0.025), and LT from deceased donor (24.2% vs. 55.0%, p = 0.004) in the 3-D printed group compared to the control group. Also, there were significant differences in age (53.6 ± 12.8 years vs. 33.5 ± 25.7 years, p = 0.002), height (163.3 ± 16.2 cm vs. 135.1 ± 42.7 cm, p = 0.008), weight (66.0 ± 15.5 kg vs. 43.8 ± 25.7 kg, p = 0.001), body mass index (BMI, 24.3 ± 4.0 kg/m 2 vs 20.7 ± 4.4 kg/m 2 , p = 0.002), etiology ( p < 0.001), total bilirubin (9.7 ± 12.5 mg/dL vs 23.1 ± 13.6 mg/dL, p < 0.001), MELD/PELD score (19.9 ± 12.5 vs 30.6 ± 10.7, p < 0.001), graft type ( p = 0.027), and GRWR (1.4 ± 0.6% vs 2.3 ± 0.8%, p < 0.001) between the two groups. After PS matching, 100 patients in control group, and 20 patients using 3-D printing models were included. There were no significant differences regarding baseline characteristics between the two groups after PS matching. Table 1 Comparison of the baseline characteristics of donors and recipients between the 3-D printed group and the control group before and after PS matching Before PS matching After PS matching No 3DP group 3DP group P-value No 3DP group 3DP group P-value SMD (N = 740) (N = 20) (N = 100) (N = 20) Sex (M/F) 515/225 (69.6) 5/15 (25.0) < 0.001 24/76 (24.0) 5/15 (25.0) 1 0.023 Age 53.6 ± 12.8 33.5 ± 25.7 0.002 39.2 ± 19.2 33.5 ± 25.7 0.351 0.254 Adult/Pediatric 713/27 (96.4) 14/6 (70.0) < 0.001 79/21 (79.0) 14/6 (70.0) 0.388 0.208 Height 163.3 ± 16.2 135.1 ± 42.7 0.008 144.8 ± 33.6 135.1 ± 42.7 0.349 0.252 Weight 66.0 ± 15.5 43.8 ± 25.7 0.001 49.3 ± 20.9 43.8 ± 25.7 0.378 0.234 BMI 24.3 ± 4.0 20.7 ± 4.4 0.002 21.5 ± 3.7 20.7 ± 4.4 0.448 0.199 Number of LT 0.025 0.485 0.347 First 699 (94.5) 16 (80.0) 86 (86.0) 16 (80.0) Second 36 (4.9) 4 (20.0) 11 (11.0) 4 (20.0) Third 5 (0.7) 0 (0.0) 3 (3.0) 0 (0.0) Etiology (HBV vs. other) < 0.001 0.19 0.441 HBV 375 (50.7) 1 (5.0) 19 (19.0) 1 (5.0) HCV 21 (2.8) 1 (5.0) 1 (1.0) 1 (5.0) Alcohol 181 (24.5) 4 (20.0) 33 (33.0) 4 (20.0) Others 163 (22.0) 14 (70.0) 47 (47.0) 14 (70.0) HCC 385 (52.0) 3 (15.0) 0.002 12 (12.0) 3 (15.0) 0.714 0.088 ABO incompatibility 147 (19.9) 0 (0.0) 0.02 12 (12.0) 0 (0.0) 0.214 0.522 Total bilirubin 9.7 ± 12.5 23.1 ± 13.6 < 0.001 16.8 ± 12.6 23.1 ± 13.6 0.065 0.484 Albumin 3.3 ± 0.6 3.1 ± 0.4 0.109 3.2 ± 0.6 3.1 ± 0.4 0.375 0.193 Creatinine 1.1 ± 1.1 1.0 ± 1.0 0.63 1.0 ± 0.9 1.0 ± 1.0 0.944 0.019 INR, PT 1.9 ± 1.5 3.8 ± 4.0 0.055 2.6 ± 1.7 3.8 ± 4.0 0.209 0.385 CTP score 8.3 ± 2.6 10.4 ± 2.0 < 0.001 9.6 ± 2.2 10.4 ± 2.0 0.101 0.402 MELD/PELD score 19.9 ± 12.5 30.6 ± 10.7 < 0.001 27.6 ± 13.1 30.6 ± 10.7 0.296 0.242 Donor sex (M/F) 432/308 (58.4) 13/7 (65.0) 0.716 56/44 (56.0) 13/7 (65.0) 0.62 0.185 Donor age 39.7 ± 15.1 42.1 ± 16.6 0.528 46.4 ± 20.2 42.1 ± 16.6 0.32 0.231 Donor height 167.8 ± 8.6 167.2 ± 10.5 0.8 166.2 ± 7.5 167.2 ± 10.5 0.714 0.1 Donor weight 66.8 ± 12.2 68.2 ± 13.6 0.639 67.0 ± 12.1 68.2 ± 13.6 0.715 0.094 Donor BMI 23.6 ± 3.2 24.4 ± 4.3 0.431 24.2 ± 3.5 24.4 ± 4.3 0.815 0.062 Living/Deceased donor 561/179 (75.8) 9/11 (45.0) 0.004 42/58 (42.0) 9/11 (45.0) 1 0.061 Graft type (Whole vs. partial) 0.027 1 0.06 Whole 165 (22.3) 9 (45.0) 48 (48.0) 9 (45.0) Right/extended right 540/8 (74.1) 3/1 (20.0) 31/1 (32.0) 3/1 (20.0) Left/extended left 5/2 (1.0) 1/1 (10.0) 0 (0.0) 1/1 (10.0) Left lateral 20 (2.7) 5 (25.0) 20 (20.0) 5 (25.0) Graft weight 866.8 ± 371.6 910.0 ± 576.3 0.743 1022.5 ± 538.4 910.0 ± 576.3 0.427 0.202 GRWR 1.4 ± 0.6 2.3 ± 0.8 < 0.001 2.2 ± 0.8 2.3 ± 0.8 0.67 0.105 Macrosteatosis 5.2 ± 6.3 3.5 ± 3.0 0.029 5.8 ± 7.6 3.5 ± 3.0 0.03 0.389 Microsteatosis 5.7 ± 7.4 3.9 ± 3.0 0.015 5.4 ± 6.7 3.9 ± 3.0 0.097 0.307 Cold ischemic time 144.0 ± 129.8 241.2 ± 213.7 0.072 220.0 ± 204.6 241.2 ± 213.7 0.701 0.101 Warm ischemic time 40.0 ± 30.9 35.3 ± 11.1 0.112 33.6 ± 19.6 35.3 ± 11.1 0.592 0.111 Propensity score PS ; 3-D printed 3DP Clinical outcomes Table 2 represents clinical outcomes between the two groups before and after PS matching. There were no significant differences in 30-day complication (63.6% vs 50.0%, p = 0.310), reoperation within 30 days (19.6% vs 20.0%, p = 1.000), large-for-size syndrome (1.8% vs 0.0%, p = 1.000), graft failure (9.2% vs 0.0% p = 0.245), and death (12.7% vs 15.0%, p = 0.726) between the two groups before PS matching. However, patients without using 3-D printing models experienced significantly higher rate of graft failure than 3-D printing group (23.0% vs 0.0%, p = 0.013) after PS matching. Table 2 Clinical outcomes between 3-D printed group and the control group before and after PS matching Before PS matching After PS matching No 3DP group 3DP group P-value No 3DP group 3DP group P-value SMD (N = 740) (N = 20) (N = 100) (N = 20) 30-day complication 471 (63.6) 10 (50.0) 0.31 64 (64.0) 10 (50.0) 0.356 0.286 C-D class ≥ IIIb 176 (23.8) 5 (25.0) 1 32 (32.0) 5 (25.0) 0.724 0.156 C-D class ≥ IV 69 (9.3) 1 (5.0) 1 18 (18.0) 1 (5.0) 0.193 0.416 Reoperation within 30 days 145 (19.6) 4 (20.0) 1 27 (27.0) 4 (20.0) 0.709 0.166 Large-for-size syndrome 12 (1.6) 0 (0.0) 1 7 ( 7.0) 0 (0.0) 0.599 0.388 Graft failure 68 (9.2) 0 (0.0) 0.245 23 (23.0) 0 (0.0) 0.013 0.751 Death 94 (12.7) 3 (15.0) 0.726 23 (23.0) 3 (15.0) 0.560 0.107 Graft survival and overall survival rate between the 3-D printed group and PS-matched control group were also evaluated using Kaplan-meier survival curve analysis (Fig. 3 ). Graft survival of PS-matched control group was inferior than that of 3-D printed group ( p = 0.034) while overall survival rate seemed similar between the two groups ( p = 0.665). Patient and printing-related data of 3-D printed group Ten out of thirteen adult recipients (76.9%) and five out of seven pediatric recipients (71.4%) were female. The median age of adult recipients was 50 years (IQR 25.5–64) and that of pediatric recipients was 0.67 year (IQR 0.5–0.8). The median heights of adult and pediatric patients were 158cm (IQR 163–166) and 73cm (IQR 60–130), respectively. We also evaluate the size of the abdominal cavity of the recipients by measuring the length of AP right liver fossa, lateral right liver fossa, and AP midline according to the CT image of those patients. The mean length of AP right liver fossa, lateral right liver fossa and AP midline of adult recipients were 15.50cm, 8.94cm, and 9.62cm, respectively. In comparison, the mean length of AP right liver fossa, lateral right liver fossa, and AP midline of pediatric recipients were 10.39cm, 5.67cm and 7.15cm, respectively (Table S1 ). The mean amount of materials required to manufacture the 3-D model was 54.3g and the mean cost of the materials was 1.25 US dollar. The mean total time taken to create 3-D abdominal cavity model was 527.0 minutes. The trend of total manufacturing time according to case number is shown in Fig. 4 . The total manufacturing time included modeling, printing, and assembling time and it became shortened as the case is repeated and recently it only took about 6 to 7 hours. Baseline characteristics and clinical course of patients with large-for-size syndrome A total of 12 patients without using 3-D printed model experienced large-for-size syndrome after LT during the study period. Baseline characteristics and clinical course of those patients are summarized in Table 3 . Among them, there was only one pediatric patient and besides two adult recipients who received liver grafts from living donors, most of the cases were deceased donor LTs. Ten out of twelve patients were unable to close their wound right after the transplantation because of increased intra-abdominal pressure leading to inadequate perfusion to the graft and bowel ischemia. Two patients required allograft fascia to completely close their wound. Three patients underwent re-transplantation due to graft failure and seven patients died after experiencing large-for-size syndrome. Table 3 Case information of patients with large-for-size syndrome including the recipient’s and donor’s characteristics and clinical outcome Recipient Donor Outcome No. Sex/age Height/ weight (cm/kg) Abdominal cavity (mm) (AP of right liver fossa/ lateral of right liver fossa/ AP of midline) Cause of liver disease and brief history MELD/ PELD Sex/age Height/ weight (cm/kg) Donor type Graft type Graft weight(g)/ GRWR(%) Complication associated with large-for-size syndrome re-LT Death 1 M/69 165/54.8 134.90/85.75/83.07 Liver cirrhosis d/t hepatitis B s/p previous abdominal surgery d/t pancreas neuroendocrine tumor 39 M/43 164/60 DD Whole liver 1923/2.90 Poor intrahepatic portal flow Unable to close the abdomen no yes 2 M/12m 88/11.0 87.50/59.12/49.20 Carbamoyl phosphate synthetase deficiency 3 F/34 161/51 DD Left lateral 376/3.30 Poor intrahepatic portal flow Delayed wound closure with alloderm graft Small bowel ischemia with perforation yes yes 3 M/51 170/62 183.53/108.74/106.61 Alcoholic liver cirrhosis 28 M/64 157/72 DD Whole liver 1895/3.05 Delayed wound closure no no 4 F/64 154/63 136.93/82.33/103.66 Toxic hepatitis 40 M/51 176/89.4 DD Whole liver 1780/2.83 Cardiac arrest d/t reperfusion syndrome poor intrahepatic portal flow Delayed wound closure no yes 5 M/49 165/53.3 150.90/88.41/88.06 Acute liver failure d/t hepatitis A 40 M/24 175/75 DD Extended right lobe 1263/2.37 IVC compression by large liver graft Delayed wound closure with fascia lata allograft no no 6 M/53 178/59.70 166.31/114.09/85.68 HCC-B Acute on chronic liver failure d/t ischemic bilopathy after salvage LDLT 38 M/47 168/79.4 DD Whole liver 1803/3.14 Delayed wound closure Poor hepatic arterial flow Luminal narrowing of extrahepatic portal vein yes yes 7 F/32 158.8/50.8 155.49/119.61/95.28 Alcoholic liver cirrhosis Acute on chronic liver failure d/t diffuse bile duct injury after LDLT 37 M/44 175/69.9 DD Whole liver 1523/3.00 Delayed wound closure Primary nonfunction of large liver graft no yes 8 F/48 169/63.8 127.54/89.76/62.20 Fulminant hepatitis A 39 M/58 171/58.5 DD Whole liver 1300/2.04 IVC compression by large liver graft Delayed wound closure no no 9 F/62 162/63.5 171.77/76.45/118.15 Liver cirrhosis d/t hepatitis B s/p previous abdominal surgery d/t endometrioid adenocarcinoma 40 F/59 155/55 DD Whole liver 1076/1.69 Delayed wound closure Small bowel ischemia with perforation no no 10 F/60 160/72.7 145.35/84.47/79.05 Acute liver failure d/t hepatitis B flare 40 M/35 168/84 DD Whole liver 1980/2.72 Unable to close the abdomen no yes 11 F/41 158.3/63.8 152.10/76.75/92.37 Autoimmune hepatitis with HCC 15 M/40 174.9/73.75 LD Right hemiliver 771/1.21 Hepatic artery thrombosis Unable to close the abdomen yes no 12 M/41 167.4/81.8 141.08/109.39/89.93 HCC Atrophy on half of the body d/t 3rd degree burn 6 F/42 159.8/75.35 LD Extended right lobe 644/0.82 Poor intrahepatic portal flow Unable to close the abdomen no yes Antero-posterior AP ; Living donor liver transplantation LDLT ; Hepatocellular carcinoma HCC ; Transcatheter arterial chemoembolization TACE ; Living donor LD ; Deceased donor DD Discussion Large-for-size syndrome after LT is not common but once it occurs, the consequences can be disastrous.[ 11 ] This usually occurs when a recipient with small abdominal cavity receives a large liver graft in cases, such as pediatric LT or LT from a male donor to a female recipient. Transplanting a large liver graft can lead to increased intra-abdominal pressure of the recipient followed by graft compression and increases the risk of vascular complication including inadequate portal and hepatic arterial flow as well as stenosis of hepatic veins. Poor oxygenation and hepatic congestion may lead to graft failure and, maybe death of a patient.[ 4 , 12 ] Recently, one study reported that the mortality rate of large-for-size syndrome after adult LT was up to 40%.[ 13 ] 3-D printing technology has developed rapidly in recent years and is being applied to various field including medicine. There also has been an effort on using 3-D printing on liver surgery but mostly focused on liver malignancy for better anatomical understanding.[ 8 , 14 – 16 ] 3-D printing in LT was also introduced in several studies.[ 9 , 17 , 18 ] Conventionally, to avoid the size discrepancy between the liver graft and the recipient, surgeons measured graft volume to predict graft-to-recipient weight ratio based on 2-D CT images.[ 3 ] However, since shape and thickness is also important, the occurrence of large-for-size syndrome could not be completely avoided especially in pediatric LT. Wang et al. successfully produced several half-sized 3-D printed models of livers for pediatric LT.[ 18 ] These studies showed that 3-D printed model could help to reduce the risk of large-for-size syndrome. 3-D printing techniques for LT in those studies focused on accurately reconstructing the anatomical structure of liver graft and showed that 3-D printing technology might be helpful for precise surgical planning. However, it is hard to apply their methods routinely due to long production time and high cost. Therefore, there has been no study yet to compare whether 3-D printing technology can lower the complication rates and improve outcomes of LT. In this study, we managed to make 3-D printed model that is easier to manufacture and can be applied to actual surgery. Our 3-D printed model developed a technique which can be a helpful tool for decision making for selecting appropriate liver graft for LT and showed a new concept of using 3-D printing technology in LT. In our preliminary study, we have already confirmed the potential of our 3-D printed model in LT since every LT case at risk of large-for-size syndrome was successfully done by using this 3-D model.[ 10 ] This is the first systematic study to show that 3-D printing technology can improve the outcome of LT compared to the traditional management. To minimize selection bias in the study, we used propensity score-matched analyses between the two groups, and the clinical outcomes were reviewed. Even though there was statistically no significant difference in the presence of large-for-size syndrome between the 3-D printed group and control group, none of the patients in 3-D printed group experienced large-for-size syndrome after LT. Patients who underwent LT using 3-D printed model showed significantly lower graft failure than the control group after PS matching. The 3-D printed group also showed superior graft survival than the control group after PS matching. One point which needs attention is that the control group after PS matching showed lower graft survival compared to the original patient group. For PS matching, variables such as sex, age, height, and weight were matched. This resulted in selecting a patient group, predominantly comprised with female, male with small body size, and pediatric recipients. Recipients with this entity has a potential of ending up with poor clinical outcome compared to ordinary body sized recipients. The reason maybe multifactorial, including lower probability of deceased donor matching due to small body size, higher risk of large-for-size syndrome, or inadequate donors for pediatric patients due to size mismatch. Although our 3-D printed model cannot solve the problem of low probability of deceased donor matching, it can help the clinicians to minimize false decision making in using a potentially large liver graft. The present study is the result of applying 3-D printing for those purposes. While we showed superior graft survival, overall survival was not different between the two groups. There were three cases with patient death in the 3-D printed group. One pediatric patient who expired due to asphyxia had comorbid condition due to combined anomaly. The patient had tracheostomy cannula which was accidentally displaced while the patient was taken care by the family members after discharge. One female recipient also expired due to asphyxia due to aspiration after discharge in her house. One female patient expired due to invasive aspergillosis which appeared four days after her re-transplantation using the 3-D printed model. All three cases were successfully transplanted without large-for-size syndrome. Although the 3-D printed model can help the surgeon to prevent large-for-size syndrome, medical condition and other surgical procedures should be handled with the same method with conventional approach. Although large-for-size syndrome is rare, surgeons should always take into account the possibility of the graft not fitting into the abdominal cavity. Therefore, understanding of the shape and size of the recipient in relation to the liver graft is essential. The 3-D printed model is not designed to reproduce the abdominal cavity as realistic as possible but only focus on the major anatomical structures such as diaphragm, parietal peritoneum, kidney, and inferior vena cava. During the study period, the manufacturing time that previously took about 2 days dramatically reduced to 6–7 hours. Unlike previous 3-D models that must be printed without interruption at once, our model undergoes procedure of printing the outlines of recipient’s abdominal cavity and then assembling each piece of printed outlines. Therefore, multiple 3-D printers can be used simultaneously to print each piece of the model, which greatly reduced printing time. Currently, we managed to reduce the manufacturing time to less than 3 hours by using two 3-D printers to reduce the printing time. This shows that we can further reduce the manufacturing time in the future. Low production cost is also another strength of our 3-D printed model. Compared to other 3-D models in previous studies, our 3-D printed model requires only one material known as polylactic acid, which is cheaper than other materials. The fused deposition type 3-D printer that we used for manufacturing the 3-D model also has the advantages of cost. The low cost and short manufacturing time allowed our team to apply the 3-D printed model in not only elective cases but also in emergency LT. In addition, due to its easy manufacturing procedure, we expect that our 3-D printed model can be easily applied in other institutes. The limitation of this study is that there may be selection bias due to small number of cases. To reduce selection bias, we performed propensity score matched analysis. In near future, we are planning to conduct multicenter study of using our 3-D printed model. Conclusions In conclusion, our novel 3-D printed model has potential to improve the graft survival and prevent large-for-size syndrome after LT. Moreover, with the advantages of cost-effectiveness and fast manufacturing time, this model could be practically utilized in LT. Abbreviations 3D, Three-dimensional; AP Antero-posterior; CT, Computed tomography; DDLT, Deceased donor liver transplantation; GRWR, Graft-recipient weight ratio; HCC, Hepatocellular carcinoma; IQR, Interquartile range; LDLT, living donor liver transplantation; LT, Liver transplantation; MELD, Model for End-stage Liver Disease Declarations Funding source This research was supported by the Basic Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science and ICT (NRF-2022R1F1A1074375). Ethics approval and consent to participate This study was approved by the Institutional Review Board (IRB No. 2022-08-101-001) of Samsung Medical Center. Informed consent was acquired from the recipients or their parents or legal guardians who were enrolled prospectively after approval of the institutional review board of Samsung Medical Center. The research was performed in accordance with relevant guidelines/regulations which were in accordance with the Declaration of Helsinki. Both the recipients and donors were not related to procurement from prisoners. Consent for publication All the authors named have read and given their approval for the manuscript. We certify that the sequence in which the authors are listed in the manuscript has received unanimous consent from all involved. Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare conflict of interest in that the protocol for producing the 3-D printed intra-abdominal cavity model is under the process of patent registration in Republic of Korea. Authors’ contributions S.P. and J.R. developed the research idea and participated in the study design and writing of the paper. S.P., J.R., G.C., J.M.K., S.L and J.J. participated in data acquisition and interpretation. S.P. and J.R. participated in statistical analysis. Each author contributed important intellectual content during manuscript drafting. J.R. provided supervision. References Burra P, Burroughs A, Graziadei I, Pirenne J, Valdecasas JC, Muiesan P, Samuel D, Forns X: EASL clinical practice guidelines: liver transplantation . Journal of hepatology 2016, 64 (2):433-485. Fukazawa K, Nishida S: Size mismatch in liver transplantation . Journal of Hepato‐Biliary‐Pancreatic Sciences 2016, 23 (8):457-466. Urata K, Kawasaki S, Matsunami H, Hashikura Y, Ikegami T, Ishizone S, Momose Y, Komiyama A, Makuuchi M: Calculation of child and adult standard liver volume for liver transplantation . Hepatology 1995, 21 (5):1317-1321. Kiuchi T, Kasahara M, Uryuhara K, Inomata Y, Uemoto S, Asonuma K, Egawa H, Fujita S, Hayashi M, Tanaka K: Impact of graft size mismatching on graft prognosis in liver transplantation from living donors1, 2 . Transplantation 1999, 67 (2):321-327. Moreira DdAR, Tannuri ACA, Belon AR, Coelho MCM, Gonçalves JO, Serafini S, Lima FR, Agostini LO, Guimarães RR, Tannuri U: Large-for-size liver transplantation: a flowmetry study in pigs . journal of surgical research 2014, 189 (2):313-320. Marro A, Bandukwala T, Mak W: Three-dimensional printing and medical imaging: a review of the methods and applications . Current problems in diagnostic radiology 2016, 45 (1):2-9. Blanco AM, Krauel L, Artés FF: Development of a patients-specific 3D-printed preoperative planning and training tool, with functionalized internal surfaces, for complex oncologic cases . Rapid Prototyping Journal 2019. Madurska MJ, Poyade M, Eason D, Rea P, Watson AJ: Development of a patient-specific 3D-printed liver model for preoperative planning . Surgical innovation 2017, 24 (2):145-150. Zein NN, Hanouneh IA, Bishop PD, Samaan M, Eghtesad B, Quintini C, Miller C, Yerian L, Klatte R: Three‐dimensional print of a liver for preoperative planning in living donor liver transplantation . Liver transplantation 2013, 19 (12):1304-1310. Park S, Choi G-S, Kim JM, Lee S, Joh J-W, Rhu J: 3D printing model of abdominal cavity of liver transplantation recipient to prevent large-for-size syndrome . Int J Bioprint 2022. Fukazawa K, Nishida S, Pretto EA, Jr., Vater Y, Reyes JD: Detrimental graft survival of size-mismatched graft for high model for end-stage liver disease recipients in liver transplantation . J Hepatobiliary Pancreat Sci 2016, 23 (7):406-413. Addeo P, Noblet V, Naegel B, Bachellier P: Large-for-size orthotopic liver transplantation: a systematic review of definitions, outcomes, and solutions . Journal of Gastrointestinal Surgery 2020, 24 (5):1192-1200. Allard MA, Lopes F, Frosio F, Golse N, Sa Cunha A, Cherqui D, Castaing D, Adam R, Vibert E: Extreme large-for-size syndrome after adult liver transplantation: A model for predicting a potentially lethal complication . Liver Transpl 2017, 23 (10):1294-1304. Marconi S, Pugliese L, Botti M, Peri A, Cavazzi E, Latteri S, Auricchio F, Pietrabissa A: Value of 3D printing for the comprehension of surgical anatomy . Surg Endosc 2017, 31 (10):4102-4110. Oshiro Y, Mitani J, Okada T, Ohkohchi N: A novel three-dimensional print of liver vessels and tumors in hepatectomy . Surgery today 2017, 47 (4):521-524. Rhu J, Kim MS, Kim S, Choi G-S, Kim JM, Joh J-W: Application of three-dimensional printing for intraoperative guidance during liver resection of a hepatocellular carcinoma with sophisticated location . Annals of Hepato-biliary-pancreatic Surgery 2021, 25 (2):265. Ikegami T, Maehara Y: 3D printing of the liver in living donor liver transplantation . Nature Reviews Gastroenterology & Hepatology 2013, 10 (12):697-698. Wang P, Que W, Zhang M, Dai X, Yu K, Wang C, Peng Z, Zhong L: Application of 3‐Dimensional Printing in Pediatric Living Donor Liver Transplantation: A Single‐Center Experience . Liver Transplantation 2019, 25 (6):831-840. Additional Declarations Competing interest reported. The authors declare conflict of interest in that the protocol for producing the 3-D printed intra-abdominal cavity model is under the process of patent registration in Republic of Korea. Supplementary Files Supportingtable.docx Cite Share Download PDF Status: Published Journal Publication published 08 Jun, 2023 Read the published version in Annals of Hepato-Biliary-Pancreatic Surgery → Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4157626","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":286284586,"identity":"1a8e6e77-e29c-42e2-bd63-5503ff31a0e8","order_by":0,"name":"Sunghae Park","email":"","orcid":"","institution":"Samsung Medical Center, Sungkyunkwan University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Sunghae","middleName":"","lastName":"Park","suffix":""},{"id":286284588,"identity":"8f7af3da-bb50-4b97-9c4a-96841318205d","order_by":1,"name":"Gyu-Seong Choi","email":"","orcid":"","institution":"Samsung Medical Center, Sungkyunkwan University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Gyu-Seong","middleName":"","lastName":"Choi","suffix":""},{"id":286284589,"identity":"24d48071-37aa-493b-8eec-24447980dc7f","order_by":2,"name":"Jongman Kim","email":"","orcid":"","institution":"Samsung Medical Center, Sungkyunkwan University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Jongman","middleName":"","lastName":"Kim","suffix":""},{"id":286284590,"identity":"a06c41c7-835c-4ec7-a46e-4df4304b7af0","order_by":3,"name":"Sanghoon Lee","email":"","orcid":"","institution":"Samsung Medical Center, Sungkyunkwan University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Sanghoon","middleName":"","lastName":"Lee","suffix":""},{"id":286284591,"identity":"551c33bb-110d-4eda-93db-a680b0052eca","order_by":4,"name":"Jae-Won Joh","email":"","orcid":"","institution":"Samsung Changwon Hospital, Sungkyunkwan University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Jae-Won","middleName":"","lastName":"Joh","suffix":""},{"id":286284592,"identity":"4c18cac7-71b0-4fd4-abf0-304a387f95c1","order_by":5,"name":"Jinsoo Rhu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAz0lEQVRIiWNgGAWjYBACxgYQWcDAwA+iEwqI1mLAwCAJYiQYEG0XUKXBASiDIGDuP/vsM4+Bjb3x+dWJHx4YMMjzix0g4LAZ6cazeQzSErfdeLtZAugww5mzEwhpYWNm5jE4nGB24+wGkJYEg9uEtPQfA2n5b2884+zmH8RpaUgDaTnAuIG/dxuRtsxIY2acY5CcOOMG7zaLBAMJwn4xBDqM4U2FnT1//9nNN39U2MjzSxPS0gBjSYBVSuBXDgLycBb/AcKqR8EoGAWjYGQCAEFAPo2PWuNxAAAAAElFTkSuQmCC","orcid":"","institution":"Samsung Medical Center, Sungkyunkwan University School of Medicine","correspondingAuthor":true,"prefix":"","firstName":"Jinsoo","middleName":"","lastName":"Rhu","suffix":""}],"badges":[],"createdAt":"2024-03-24 10:48:42","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4157626/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4157626/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.14701/ahbps.2023S1.OP-4-2","type":"published","date":"2023-06-08T17:23:09+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":54039646,"identity":"fda3b980-e5ff-4457-b80f-46d3e4ad6e43","added_by":"auto","created_at":"2024-04-03 17:22:40","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":1966959,"visible":true,"origin":"","legend":"\u003cp\u003eThe workflow of manufacturing 3-D printed abdominal cavity model and its application in both deceased donor LT and living donor LT\u003c/p\u003e","description":"","filename":"fig1.png","url":"https://assets-eu.researchsquare.com/files/rs-4157626/v1/b7f08242a547481a72b07eea.png"},{"id":54039648,"identity":"da1f9252-b777-4c61-a75d-34160e464177","added_by":"auto","created_at":"2024-04-03 17:22:41","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":6189408,"visible":true,"origin":"","legend":"\u003cp\u003eThe actual application of 3-D printed model during deceased donor LT (A) and living donor LT (B)\u003c/p\u003e","description":"","filename":"Fig2.png","url":"https://assets-eu.researchsquare.com/files/rs-4157626/v1/914ecde95722ce74a141bf35.png"},{"id":54039645,"identity":"a03f22ff-8c57-4b42-ac30-bbf0649e738c","added_by":"auto","created_at":"2024-04-03 17:22:40","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":161057,"visible":true,"origin":"","legend":"\u003cp\u003eGraft survival (A) and Overall survival (B) between 3-D printed group and the control group after PS matching\u003c/p\u003e","description":"","filename":"Fig3.png","url":"https://assets-eu.researchsquare.com/files/rs-4157626/v1/8ed7b5afcd202d23de44d278.png"},{"id":54039649,"identity":"9ef8dcfe-3b1f-45a7-b191-c585c6941e81","added_by":"auto","created_at":"2024-04-03 17:22:41","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":233934,"visible":true,"origin":"","legend":"\u003cp\u003eTotal manufacturing time according to (A) only cases (\u003cem\u003en\u003c/em\u003e = 20) included to the study and (B) all the manufactured cases (\u003cem\u003en\u003c/em\u003e= 29) including non-operated cases\u003c/p\u003e","description":"","filename":"Fig4.png","url":"https://assets-eu.researchsquare.com/files/rs-4157626/v1/cd76205531c2eb16c2c6e792.png"},{"id":54040219,"identity":"0fa4c4d8-189a-4d88-acb3-0f1acac224a0","added_by":"auto","created_at":"2024-04-03 17:30:49","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":3429278,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4157626/v1/097435e6-d0ed-4e7c-b032-56ab48d09a2a.pdf"},{"id":54039651,"identity":"3a5a3b51-89bd-452a-a97d-f0af9668800d","added_by":"auto","created_at":"2024-04-03 17:22:41","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":28708,"visible":true,"origin":"","legend":"","description":"","filename":"Supportingtable.docx","url":"https://assets-eu.researchsquare.com/files/rs-4157626/v1/5b0c966b52f6e1dfe71e7a1d.docx"}],"financialInterests":"Competing interest reported. The authors declare conflict of interest in that the protocol for producing the 3-D printed intra-abdominal cavity model is under the process of patent registration in Republic of Korea.","formattedTitle":"Improved graft survival by using three-dimensional printing of intra- abdominal cavity to prevent large-for-size syndrome in liver transplantation","fulltext":[{"header":"Background","content":"\u003cp\u003eLiver transplantation (LT) is standard therapy for acute and chronic liver failure and has evolved rapidly due to the advancement of immunosuppressive agents and surgical techniques.[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] However, severe organ shortage remains as an unresolved issue and only limited number of LT candidates can receive liver grafts. To make sure for the success of LT, the size of the expected graft should be adequate for the recipient. When the liver graft is too small for the recipient, small-for-size syndrome can occur, and it can usually be predicted by calculating the graft-recipient-weight ratio (GRWR).[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] On the other hand, when a liver graft is too large to fit inside the abdominal cavity, large-for-size syndrome can occur.[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e] Although the incidence of large-for-size syndrome is low, fatal outcome can occur due to graft compression, followed by poor oxygen supply leading to graft dysfunction.[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e] Therefore, understanding the size of the recipient\u0026rsquo;s abdominal cavity in relation to graft liver volume is significant to prevent large-for-size syndrome. While the risk of large-for-size syndrome is quite low for living donor LT (LDLT) since the donor is also evaluated before transplant, deceased donors have limitation in pre-transplant evaluation and there is always a risk for the graft being too large for recipients who have small intra-abdominal cavity.\u003c/p\u003e \u003cp\u003eThree-dimensional (3-D) printing with its potential as personalized medical tool has started to be utilized in medicine especially in maxillofacial and craniofacial surgery.[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] There also has been an effort for using 3-D printing in the field of liver surgery but mostly focused on understanding the anatomical structures.[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] In 2013, the use of 3-D printing in LT was first introduced by the literature of Zein et al. and has been continuously developed but still it is too expensive and time-consuming to be practically utilized.[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] To maximize its utility, our team managed to focus on reconstructing the LT recipients\u0026rsquo; abdominal cavity by its actual size while minimizing the time for manufacturing. Our initial experience on utilizing our 3-D printing protocol for LT recipients with small abdominal cavity showed successful clinical outcome with short manufacturing time.[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] By the successful application of 3-D printing for preventing large-for-size syndrome in recipients with potential risk, we designed this study to analyze whether the 3-D printed abdominal cavity protocol actually improved our clinical practice by comparing the clinical outcome of patients with 3-D printing to patients without 3-D printing using propensity score (PS) matching.\u003c/p\u003e"},{"header":"MATERIALs and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003ePatient selection of 3-D printing of abdominal cavity\u003c/h2\u003e \u003cp\u003eThe study included a total of 760 patients who underwent LT between January 2017 and March 2022. Among these patients, twenty patients had their abdominal cavity manufactured using a 3-D printed model. The selection of patients for this process was based on the operator's decision, taking into account the spatial relationship between the recipient's liver fossa and the liver graft. Patients with small-sized abdominal cavities, mostly female or pediatric recipients, were chosen. In cases of LDLT, patients with an expected graft-recipient weight ratio (GRWR) exceeding 2% or a liver graft larger than 1000cm\u003csup\u003e3\u003c/sup\u003e were selected for 3-D printing of the intra-abdominal cavity.\u003c/p\u003e \u003cp\u003eFor patients on the waiting list for a deceased donor match, the following criteria were used for printing a 3-D model: (1) female recipients who were not 10 cm taller than the allocated male donor, (2) male recipients who were at least 10 cm shorter than the allocated female donor, (3) matches of the same sex where the recipient was at least 10 cm shorter than the donor, and (4) individuals with a small right liver fossa, defined as an anteroposterior (AP) length of \u0026le;\u0026thinsp;13 cm or a lateral space from the inferior vena cava of \u0026le;\u0026thinsp;10 cm. Additionally, the transplant surgeon's judgment played a role in the selection process, especially when the recipient had an abdominal cavity deformity that did not fit the mentioned criteria.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e3-D modeling of the recipient\u0026rsquo;s abdominal cavity\u003c/h2\u003e \u003cp\u003eThe workflow for creating and applying a 3-D printed model in both living donor and deceased donor liver transplantation (LT) is depicted in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The process begins with the recipient's computed tomography (CT) scan, which is used to outline the inner space of the abdominal cavity where the graft liver will be positioned. Mimics Medical 21.0 (Materialise, Leuven, Belgium) is employed for this purpose. The inner surface of the abdominal cavity, excluding the medial two-thirds of the anterior wall, is outlined with a 1 to 3 centimeter gap between slices. In the case of adult recipients, only the right half of the abdomen is outlined, whereas both the right and left halves are outlined for pediatric recipients and adults undergoing left liver transplantation.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eOnce the outline of the intra-abdominal cavity is marked, the lines are reconstructed into a 3-D model using Cinema 4D (Maxon, Friedrichsdorf, Germany). Subsequently, the 3-D model is printed individually using Cubicreator software and Cubicon Single Plus (Cubicon, Seong nam, Republic of Korea), a fused deposition modeling type 3-D printer. After printing, each piece is assembled to create the final 3-D printed model. This model assists in the decision-making process of whether to utilize a specific liver graft or not. The application of the 3-D printed abdominal cavity model during LT decision-making is depicted in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eData acquisition\u003c/h2\u003e \u003cp\u003eBaseline characteristics of the donor and recipient for both 3-D printed group and the control group were collected. In addition, data of graft, recipients\u0026rsquo; abdominal cavity, and 3-D model were collected. Graft data included type of graft, weight, and GRWR. We measured AP and lateral length of right liver fossa, and AP length of midline of recipients to roughly estimate the abdominal cavity based on CT of recipients before LT. Data regarding 3-D printed model included amount of materials, cost and manufacturing time needed for 3-D printing. The clinical course before and after using the 3-D printed model was also collected. In addition, demographical data and clinical course of the patients who experienced large-for-size syndrome during the study period were collected.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eTo reduce the impact of selection bias, we performed a 1:5 ratio PS matching analysis with nearest neighbor method between the 3-D printed group and the control group. The control group was consisted of patients who underwent LT without using 3-D printing model during January 2017 to March 2022. The PS of each case was calculated using a multivariable logistic regression model by including variables such as sex, age, height, weight, adult or pediatric, LT from living or deceased donor, graft type, graft weight, donor sex, donor age, donor height, and donor weight. After PS matching, 20 cases in the 3-D printed group were matched to 100 cases in the control group.\u003c/p\u003e \u003cp\u003eThe outcomes between the 3-D printed group and the control group were compared, such as 30-day complication of recipients, reoperation within 30 days, large-for-size syndrome, graft failure and death of recipient. Numerical variables were compared with the Student \u003cem\u003et\u003c/em\u003e test or Mann-Whitney U test and expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation or median (interquartile range [IQR]), respectively. Categorical variables were compared with chi-square test or Fisher\u0026rsquo;s exact test. Kaplan-Meier survival curve analysis was performed to estimate the graft survival and overall survival rates after PS matching. Statistical analyses were performed using SPSS 26.0 (SPSS Inc., Chicago, IL) and R version 4.1.1 (R Foundation for Statistical Computing, Vienna, Austria). This study was approved by the Institutional Review Board (IRB No. 2022-08-101-001).\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eBaseline characteristics before and after PS matching\u003c/h2\u003e \u003cp\u003eAmong 760 patients who underwent LT between July 2020 to March 2022, 20 patients underwent LT using 3-D printed abdominal cavity models.\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e summarizes the baseline characteristics of donors and recipients between the 3-D printed group and the control group before and after PS matching. Before PS matching, there were higher proportion of female patients (30.3% vs. 75.0%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), pediatric patients (3.6% vs. 30.0%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), re-LT patients (5.6% vs. 20.0%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.025), and LT from deceased donor (24.2% vs. 55.0%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.004) in the 3-D printed group compared to the control group. Also, there were significant differences in age (53.6\u0026thinsp;\u0026plusmn;\u0026thinsp;12.8 years vs. 33.5\u0026thinsp;\u0026plusmn;\u0026thinsp;25.7 years, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.002), height (163.3\u0026thinsp;\u0026plusmn;\u0026thinsp;16.2 cm vs. 135.1\u0026thinsp;\u0026plusmn;\u0026thinsp;42.7 cm, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.008), weight (66.0\u0026thinsp;\u0026plusmn;\u0026thinsp;15.5 kg vs. 43.8\u0026thinsp;\u0026plusmn;\u0026thinsp;25.7 kg, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001), body mass index (BMI, 24.3\u0026thinsp;\u0026plusmn;\u0026thinsp;4.0 kg/m\u003csup\u003e2\u003c/sup\u003e vs 20.7\u0026thinsp;\u0026plusmn;\u0026thinsp;4.4 kg/m\u003csup\u003e2\u003c/sup\u003e, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.002), etiology (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), total bilirubin (9.7\u0026thinsp;\u0026plusmn;\u0026thinsp;12.5 mg/dL vs 23.1\u0026thinsp;\u0026plusmn;\u0026thinsp;13.6 mg/dL, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), MELD/PELD score (19.9\u0026thinsp;\u0026plusmn;\u0026thinsp;12.5 vs 30.6\u0026thinsp;\u0026plusmn;\u0026thinsp;10.7, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), graft type (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.027), and GRWR (1.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6% vs 2.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.8%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) between the two groups. After PS matching, 100 patients in control group, and 20 patients using 3-D printing models were included. There were no significant differences regarding baseline characteristics between the two groups after PS matching.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of the baseline characteristics of donors and recipients between the 3-D printed group and the control group before and after PS matching\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eBefore PS matching\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c9\" namest=\"c6\"\u003e \u003cp\u003eAfter PS matching\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo 3DP group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3DP group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo 3DP group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3DP group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSMD\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;740)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;20)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex (M/F)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e515/225 (69.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5/15 (25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e24/76 (24.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5/15 (25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.023\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e53.6\u0026thinsp;\u0026plusmn;\u0026thinsp;12.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.5\u0026thinsp;\u0026plusmn;\u0026thinsp;25.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e39.2\u0026thinsp;\u0026plusmn;\u0026thinsp;19.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e33.5\u0026thinsp;\u0026plusmn;\u0026thinsp;25.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.351\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.254\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdult/Pediatric\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e713/27 (96.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14/6 (70.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e79/21 (79.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e14/6 (70.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.388\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.208\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHeight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e163.3\u0026thinsp;\u0026plusmn;\u0026thinsp;16.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e135.1\u0026thinsp;\u0026plusmn;\u0026thinsp;42.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e144.8\u0026thinsp;\u0026plusmn;\u0026thinsp;33.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e135.1\u0026thinsp;\u0026plusmn;\u0026thinsp;42.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.349\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.252\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e66.0\u0026thinsp;\u0026plusmn;\u0026thinsp;15.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43.8\u0026thinsp;\u0026plusmn;\u0026thinsp;25.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e49.3\u0026thinsp;\u0026plusmn;\u0026thinsp;20.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e43.8\u0026thinsp;\u0026plusmn;\u0026thinsp;25.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.378\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.234\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24.3\u0026thinsp;\u0026plusmn;\u0026thinsp;4.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.7\u0026thinsp;\u0026plusmn;\u0026thinsp;4.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e21.5\u0026thinsp;\u0026plusmn;\u0026thinsp;3.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e20.7\u0026thinsp;\u0026plusmn;\u0026thinsp;4.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.448\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.199\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of LT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.485\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.347\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFirst\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e699 (94.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (80.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e86 (86.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e16 (80.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecond\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36 (4.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11 (11.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThird\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (0.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3 (3.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEtiology (HBV vs. other)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.441\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHBV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e375 (50.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (5.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19 (19.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1 (5.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHCV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21 (2.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (5.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (1.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1 (5.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlcohol\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e181 (24.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e33 (33.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e163 (22.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (70.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e47 (47.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e14 (70.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHCC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e385 (52.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (15.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12 (12.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3 (15.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.714\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.088\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eABO incompatibility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e147 (19.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12 (12.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.214\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.522\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal bilirubin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.7\u0026thinsp;\u0026plusmn;\u0026thinsp;12.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.1\u0026thinsp;\u0026plusmn;\u0026thinsp;13.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e16.8\u0026thinsp;\u0026plusmn;\u0026thinsp;12.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e23.1\u0026thinsp;\u0026plusmn;\u0026thinsp;13.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.065\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.484\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlbumin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.109\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.375\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.193\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCreatinine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.0\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.944\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.019\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eINR, PT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.8\u0026thinsp;\u0026plusmn;\u0026thinsp;4.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.055\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.8\u0026thinsp;\u0026plusmn;\u0026thinsp;4.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.209\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.385\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCTP score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.3\u0026thinsp;\u0026plusmn;\u0026thinsp;2.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.4\u0026thinsp;\u0026plusmn;\u0026thinsp;2.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e9.6\u0026thinsp;\u0026plusmn;\u0026thinsp;2.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e10.4\u0026thinsp;\u0026plusmn;\u0026thinsp;2.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.402\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMELD/PELD score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19.9\u0026thinsp;\u0026plusmn;\u0026thinsp;12.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30.6\u0026thinsp;\u0026plusmn;\u0026thinsp;10.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e27.6\u0026thinsp;\u0026plusmn;\u0026thinsp;13.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e30.6\u0026thinsp;\u0026plusmn;\u0026thinsp;10.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.296\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.242\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDonor sex (M/F)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e432/308 (58.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13/7 (65.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.716\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e56/44 (56.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e13/7 (65.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.185\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDonor age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e39.7\u0026thinsp;\u0026plusmn;\u0026thinsp;15.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42.1\u0026thinsp;\u0026plusmn;\u0026thinsp;16.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.528\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e46.4\u0026thinsp;\u0026plusmn;\u0026thinsp;20.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e42.1\u0026thinsp;\u0026plusmn;\u0026thinsp;16.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.231\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDonor height\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e167.8\u0026thinsp;\u0026plusmn;\u0026thinsp;8.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e167.2\u0026thinsp;\u0026plusmn;\u0026thinsp;10.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e166.2\u0026thinsp;\u0026plusmn;\u0026thinsp;7.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e167.2\u0026thinsp;\u0026plusmn;\u0026thinsp;10.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.714\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDonor weight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e66.8\u0026thinsp;\u0026plusmn;\u0026thinsp;12.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68.2\u0026thinsp;\u0026plusmn;\u0026thinsp;13.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.639\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e67.0\u0026thinsp;\u0026plusmn;\u0026thinsp;12.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e68.2\u0026thinsp;\u0026plusmn;\u0026thinsp;13.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.715\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.094\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDonor BMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23.6\u0026thinsp;\u0026plusmn;\u0026thinsp;3.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.4\u0026thinsp;\u0026plusmn;\u0026thinsp;4.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.431\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e24.2\u0026thinsp;\u0026plusmn;\u0026thinsp;3.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e24.4\u0026thinsp;\u0026plusmn;\u0026thinsp;4.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.815\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.062\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLiving/Deceased donor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e561/179 (75.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9/11 (45.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e42/58 (42.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e9/11 (45.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.061\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGraft type \u003c/p\u003e \u003cp\u003e(Whole vs. partial)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.027\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhole\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e165 (22.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (45.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e48 (48.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e9 (45.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRight/extended right\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e540/8 (74.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3/1 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e31/1 (32.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3/1 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLeft/extended left\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5/2 (1.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1/1 (10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1/1 (10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLeft lateral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20 (2.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5 (25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGraft weight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e866.8\u0026thinsp;\u0026plusmn;\u0026thinsp;371.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e910.0\u0026thinsp;\u0026plusmn;\u0026thinsp;576.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.743\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1022.5\u0026thinsp;\u0026plusmn;\u0026thinsp;538.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e910.0\u0026thinsp;\u0026plusmn;\u0026thinsp;576.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.427\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.202\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGRWR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.105\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMacrosteatosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.2\u0026thinsp;\u0026plusmn;\u0026thinsp;6.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.5\u0026thinsp;\u0026plusmn;\u0026thinsp;3.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.029\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.8\u0026thinsp;\u0026plusmn;\u0026thinsp;7.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.5\u0026thinsp;\u0026plusmn;\u0026thinsp;3.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.389\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMicrosteatosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.7\u0026thinsp;\u0026plusmn;\u0026thinsp;7.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.9\u0026thinsp;\u0026plusmn;\u0026thinsp;3.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.4\u0026thinsp;\u0026plusmn;\u0026thinsp;6.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.9\u0026thinsp;\u0026plusmn;\u0026thinsp;3.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.097\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.307\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCold ischemic time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e144.0\u0026thinsp;\u0026plusmn;\u0026thinsp;129.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e241.2\u0026thinsp;\u0026plusmn;\u0026thinsp;213.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.072\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e220.0\u0026thinsp;\u0026plusmn;\u0026thinsp;204.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e241.2\u0026thinsp;\u0026plusmn;\u0026thinsp;213.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.701\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.101\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWarm ischemic time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40.0\u0026thinsp;\u0026plusmn;\u0026thinsp;30.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35.3\u0026thinsp;\u0026plusmn;\u0026thinsp;11.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e33.6\u0026thinsp;\u0026plusmn;\u0026thinsp;19.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e35.3\u0026thinsp;\u0026plusmn;\u0026thinsp;11.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.592\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.111\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"9\"\u003ePropensity score \u003cb\u003ePS\u003c/b\u003e; 3-D printed \u003cb\u003e3DP\u003c/b\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eClinical outcomes\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e represents clinical outcomes between the two groups before and after PS matching. There were no significant differences in 30-day complication (63.6% vs 50.0%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.310), reoperation within 30 days (19.6% vs 20.0%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.000), large-for-size syndrome (1.8% vs 0.0%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.000), graft failure (9.2% vs 0.0% \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.245), and death (12.7% vs 15.0%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.726) between the two groups before PS matching. However, patients without using 3-D printing models experienced significantly higher rate of graft failure than 3-D printing group (23.0% vs 0.0%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.013) after PS matching.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eClinical outcomes between 3-D printed group and the control group before and after PS matching\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eBefore PS matching\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c9\" namest=\"c6\"\u003e \u003cp\u003eAfter PS matching\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo 3DP group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3DP group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo 3DP group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3DP group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSMD\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;740)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;20)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30-day complication\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e471 (63.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e64 (64.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e10 (50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.356\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.286\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eC-D class\u0026thinsp;\u0026ge;\u0026thinsp;IIIb\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e176 (23.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e32 (32.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5 (25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.724\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.156\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eC-D class\u0026thinsp;\u0026ge;\u0026thinsp;IV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69 (9.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (5.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18 (18.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1 (5.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.193\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.416\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReoperation within 30 days\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e145 (19.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e27 (27.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.709\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.166\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLarge-for-size syndrome\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12 (1.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7 ( 7.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.599\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.388\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGraft failure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e68 (9.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.245\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e23 (23.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.751\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDeath\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e94 (12.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (15.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.726\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e23 (23.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3 (15.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.560\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.107\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eGraft survival and overall survival rate between the 3-D printed group and PS-matched control group were also evaluated using Kaplan-meier survival curve analysis (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Graft survival of PS-matched control group was inferior than that of 3-D printed group (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.034) while overall survival rate seemed similar between the two groups (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.665).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003ePatient and printing-related data of 3-D printed group\u003c/h3\u003e\n\u003cp\u003eTen out of thirteen adult recipients (76.9%) and five out of seven pediatric recipients (71.4%) were female. The median age of adult recipients was 50 years (IQR 25.5\u0026ndash;64) and that of pediatric recipients was 0.67 year (IQR 0.5\u0026ndash;0.8). The median heights of adult and pediatric patients were 158cm (IQR 163\u0026ndash;166) and 73cm (IQR 60\u0026ndash;130), respectively. We also evaluate the size of the abdominal cavity of the recipients by measuring the length of AP right liver fossa, lateral right liver fossa, and AP midline according to the CT image of those patients. The mean length of AP right liver fossa, lateral right liver fossa and AP midline of adult recipients were 15.50cm, 8.94cm, and 9.62cm, respectively. In comparison, the mean length of AP right liver fossa, lateral right liver fossa, and AP midline of pediatric recipients were 10.39cm, 5.67cm and 7.15cm, respectively (Table \u003cspan refid=\"MOESM1\" class=\"InternalRef\"\u003eS1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe mean amount of materials required to manufacture the 3-D model was 54.3g and the mean cost of the materials was 1.25 US dollar. The mean total time taken to create 3-D abdominal cavity model was 527.0 minutes. The trend of total manufacturing time according to case number is shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. The total manufacturing time included modeling, printing, and assembling time and it became shortened as the case is repeated and recently it only took about 6 to 7 hours.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eBaseline characteristics and clinical course of patients with large-for-size syndrome\u003c/h2\u003e \u003cp\u003eA total of 12 patients without using 3-D printed model experienced large-for-size syndrome after LT during the study period. Baseline characteristics and clinical course of those patients are summarized in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. Among them, there was only one pediatric patient and besides two adult recipients who received liver grafts from living donors, most of the cases were deceased donor LTs. Ten out of twelve patients were unable to close their wound right after the transplantation because of increased intra-abdominal pressure leading to inadequate perfusion to the graft and bowel ischemia. Two patients required allograft fascia to completely close their wound. Three patients underwent re-transplantation due to graft failure and seven patients died after experiencing large-for-size syndrome.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCase information of patients with large-for-size syndrome including the recipient\u0026rsquo;s and donor\u0026rsquo;s characteristics and clinical outcome\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"15\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c15\" colnum=\"15\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eRecipient\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c11\" namest=\"c7\"\u003e \u003cp\u003eDonor\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c15\" namest=\"c12\"\u003e \u003cp\u003eOutcome\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSex/age\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHeight/\u003c/p\u003e \u003cp\u003eweight (cm/kg)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAbdominal cavity (mm)\u003c/p\u003e \u003cp\u003e(AP of right liver fossa/ lateral of right liver fossa/ AP of midline)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCause of liver disease\u003c/p\u003e \u003cp\u003eand brief history\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMELD/\u003c/p\u003e \u003cp\u003ePELD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eSex/age\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eHeight/\u003c/p\u003e \u003cp\u003eweight (cm/kg)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eDonor type\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eGraft type\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003eGraft weight(g)/\u003c/p\u003e \u003cp\u003eGRWR(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003eComplication associated \u003c/p\u003e \u003cp\u003ewith large-for-size syndrome\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c13\"\u003e \u003cp\u003ere-LT\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c14\"\u003e \u003cp\u003eDeath\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eM/69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e165/54.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e134.90/85.75/83.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLiver cirrhosis d/t hepatitis B\u003c/p\u003e \u003cp\u003es/p previous abdominal surgery d/t pancreas neuroendocrine tumor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eM/43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e164/60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eDD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eWhole liver\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1923/2.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003ePoor intrahepatic portal flow\u003c/p\u003e \u003cp\u003eUnable to close the abdomen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eM/12m\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e88/11.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e87.50/59.12/49.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCarbamoyl phosphate synthetase deficiency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eF/34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e161/51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eDD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eLeft lateral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e376/3.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003ePoor intrahepatic portal flow\u003c/p\u003e \u003cp\u003eDelayed wound closure with alloderm graft\u003c/p\u003e \u003cp\u003eSmall bowel ischemia with perforation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eM/51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e170/62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e183.53/108.74/106.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAlcoholic liver cirrhosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eM/64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e157/72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eDD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eWhole liver\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1895/3.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eDelayed wound closure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eF/64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e154/63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e136.93/82.33/103.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eToxic hepatitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eM/51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e176/89.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eDD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eWhole liver\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1780/2.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eCardiac arrest d/t reperfusion syndrome\u003c/p\u003e \u003cp\u003epoor intrahepatic portal flow\u003c/p\u003e \u003cp\u003eDelayed wound closure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eM/49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e165/53.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e150.90/88.41/88.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAcute liver failure d/t hepatitis A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eM/24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e175/75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eDD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eExtended right lobe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1263/2.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eIVC compression by large liver graft\u003c/p\u003e \u003cp\u003eDelayed wound closure with fascia lata allograft\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eM/53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e178/59.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e166.31/114.09/85.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHCC-B\u003c/p\u003e \u003cp\u003eAcute on chronic liver failure d/t ischemic bilopathy after salvage LDLT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eM/47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e168/79.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eDD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eWhole liver\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1803/3.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eDelayed wound closure\u003c/p\u003e \u003cp\u003ePoor hepatic arterial flow\u003c/p\u003e \u003cp\u003eLuminal narrowing of extrahepatic portal vein\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eF/32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e158.8/50.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e155.49/119.61/95.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAlcoholic liver cirrhosis\u003c/p\u003e \u003cp\u003eAcute on chronic liver failure d/t diffuse bile duct injury after LDLT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eM/44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e175/69.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eDD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eWhole liver\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1523/3.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eDelayed wound closure\u003c/p\u003e \u003cp\u003ePrimary nonfunction of large liver graft\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eF/48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e169/63.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e127.54/89.76/62.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFulminant hepatitis A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eM/58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e171/58.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eDD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eWhole liver\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1300/2.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eIVC compression by large liver graft\u003c/p\u003e \u003cp\u003eDelayed wound closure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eF/62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e162/63.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e171.77/76.45/118.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLiver cirrhosis d/t hepatitis B\u003c/p\u003e \u003cp\u003es/p previous abdominal surgery d/t endometrioid adenocarcinoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eF/59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e155/55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eDD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eWhole liver\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1076/1.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eDelayed wound closure\u003c/p\u003e \u003cp\u003eSmall bowel ischemia with perforation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eF/60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e160/72.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e145.35/84.47/79.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAcute liver failure d/t hepatitis B flare\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eM/35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e168/84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eDD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eWhole liver\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1980/2.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eUnable to close the abdomen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eF/41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e158.3/63.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e152.10/76.75/92.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAutoimmune hepatitis with HCC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eM/40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e174.9/73.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eLD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eRight hemiliver\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e771/1.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eHepatic artery thrombosis\u003c/p\u003e \u003cp\u003eUnable to close the abdomen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eM/41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e167.4/81.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e141.08/109.39/89.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHCC\u003c/p\u003e \u003cp\u003eAtrophy on half of the body d/t 3rd degree burn\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eF/42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e159.8/75.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eLD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eExtended right lobe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e644/0.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003ePoor intrahepatic portal flow\u003c/p\u003e \u003cp\u003eUnable to close the abdomen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003eyes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"15\" nameend=\"c15\" namest=\"c1\"\u003e \u003cp\u003eAntero-posterior \u003cb\u003eAP\u003c/b\u003e; Living donor liver transplantation \u003cb\u003eLDLT\u003c/b\u003e; Hepatocellular carcinoma \u003cb\u003eHCC\u003c/b\u003e; Transcatheter arterial chemoembolization \u003cb\u003eTACE\u003c/b\u003e; Living donor \u003cb\u003eLD\u003c/b\u003e; Deceased donor \u003cb\u003eDD\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eLarge-for-size syndrome after LT is not common but once it occurs, the consequences can be disastrous.[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] This usually occurs when a recipient with small abdominal cavity receives a large liver graft in cases, such as pediatric LT or LT from a male donor to a female recipient. Transplanting a large liver graft can lead to increased intra-abdominal pressure of the recipient followed by graft compression and increases the risk of vascular complication including inadequate portal and hepatic arterial flow as well as stenosis of hepatic veins. Poor oxygenation and hepatic congestion may lead to graft failure and, maybe death of a patient.[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] Recently, one study reported that the mortality rate of large-for-size syndrome after adult LT was up to 40%.[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/p\u003e \u003cp\u003e3-D printing technology has developed rapidly in recent years and is being applied to various field including medicine. There also has been an effort on using 3-D printing on liver surgery but mostly focused on liver malignancy for better anatomical understanding.[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan additionalcitationids=\"CR15\" citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] 3-D printing in LT was also introduced in several studies.[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] Conventionally, to avoid the size discrepancy between the liver graft and the recipient, surgeons measured graft volume to predict graft-to-recipient weight ratio based on 2-D CT images.[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] However, since shape and thickness is also important, the occurrence of large-for-size syndrome could not be completely avoided especially in pediatric LT. Wang et al. successfully produced several half-sized 3-D printed models of livers for pediatric LT.[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] These studies showed that 3-D printed model could help to reduce the risk of large-for-size syndrome. 3-D printing techniques for LT in those studies focused on accurately reconstructing the anatomical structure of liver graft and showed that 3-D printing technology might be helpful for precise surgical planning. However, it is hard to apply their methods routinely due to long production time and high cost. Therefore, there has been no study yet to compare whether 3-D printing technology can lower the complication rates and improve outcomes of LT. In this study, we managed to make 3-D printed model that is easier to manufacture and can be applied to actual surgery.\u003c/p\u003e \u003cp\u003eOur 3-D printed model developed a technique which can be a helpful tool for decision making for selecting appropriate liver graft for LT and showed a new concept of using 3-D printing technology in LT. In our preliminary study, we have already confirmed the potential of our 3-D printed model in LT since every LT case at risk of large-for-size syndrome was successfully done by using this 3-D model.[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] This is the first systematic study to show that 3-D printing technology can improve the outcome of LT compared to the traditional management. To minimize selection bias in the study, we used propensity score-matched analyses between the two groups, and the clinical outcomes were reviewed. Even though there was statistically no significant difference in the presence of large-for-size syndrome between the 3-D printed group and control group, none of the patients in 3-D printed group experienced large-for-size syndrome after LT. Patients who underwent LT using 3-D printed model showed significantly lower graft failure than the control group after PS matching. The 3-D printed group also showed superior graft survival than the control group after PS matching.\u003c/p\u003e \u003cp\u003eOne point which needs attention is that the control group after PS matching showed lower graft survival compared to the original patient group. For PS matching, variables such as sex, age, height, and weight were matched. This resulted in selecting a patient group, predominantly comprised with female, male with small body size, and pediatric recipients. Recipients with this entity has a potential of ending up with poor clinical outcome compared to ordinary body sized recipients. The reason maybe multifactorial, including lower probability of deceased donor matching due to small body size, higher risk of large-for-size syndrome, or inadequate donors for pediatric patients due to size mismatch. Although our 3-D printed model cannot solve the problem of low probability of deceased donor matching, it can help the clinicians to minimize false decision making in using a potentially large liver graft. The present study is the result of applying 3-D printing for those purposes.\u003c/p\u003e \u003cp\u003eWhile we showed superior graft survival, overall survival was not different between the two groups. There were three cases with patient death in the 3-D printed group. One pediatric patient who expired due to asphyxia had comorbid condition due to combined anomaly. The patient had tracheostomy cannula which was accidentally displaced while the patient was taken care by the family members after discharge. One female recipient also expired due to asphyxia due to aspiration after discharge in her house. One female patient expired due to invasive aspergillosis which appeared four days after her re-transplantation using the 3-D printed model. All three cases were successfully transplanted without large-for-size syndrome. Although the 3-D printed model can help the surgeon to prevent large-for-size syndrome, medical condition and other surgical procedures should be handled with the same method with conventional approach.\u003c/p\u003e \u003cp\u003eAlthough large-for-size syndrome is rare, surgeons should always take into account the possibility of the graft not fitting into the abdominal cavity. Therefore, understanding of the shape and size of the recipient in relation to the liver graft is essential. The 3-D printed model is not designed to reproduce the abdominal cavity as realistic as possible but only focus on the major anatomical structures such as diaphragm, parietal peritoneum, kidney, and inferior vena cava. During the study period, the manufacturing time that previously took about 2 days dramatically reduced to 6\u0026ndash;7 hours. Unlike previous 3-D models that must be printed without interruption at once, our model undergoes procedure of printing the outlines of recipient\u0026rsquo;s abdominal cavity and then assembling each piece of printed outlines. Therefore, multiple 3-D printers can be used simultaneously to print each piece of the model, which greatly reduced printing time. Currently, we managed to reduce the manufacturing time to less than 3 hours by using two 3-D printers to reduce the printing time. This shows that we can further reduce the manufacturing time in the future.\u003c/p\u003e \u003cp\u003eLow production cost is also another strength of our 3-D printed model. Compared to other 3-D models in previous studies, our 3-D printed model requires only one material known as polylactic acid, which is cheaper than other materials. The fused deposition type 3-D printer that we used for manufacturing the 3-D model also has the advantages of cost. The low cost and short manufacturing time allowed our team to apply the 3-D printed model in not only elective cases but also in emergency LT. In addition, due to its easy manufacturing procedure, we expect that our 3-D printed model can be easily applied in other institutes.\u003c/p\u003e \u003cp\u003eThe limitation of this study is that there may be selection bias due to small number of cases. To reduce selection bias, we performed propensity score matched analysis. In near future, we are planning to conduct multicenter study of using our 3-D printed model.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIn conclusion, our novel 3-D printed model has potential to improve the graft survival and prevent large-for-size syndrome after LT. Moreover, with the advantages of cost-effectiveness and fast manufacturing time, this model could be practically utilized in LT.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e3D, Three-dimensional; AP Antero-posterior; CT, Computed tomography; DDLT, Deceased donor liver transplantation; GRWR, Graft-recipient weight ratio; HCC, Hepatocellular carcinoma; IQR, Interquartile range; LDLT, living donor liver transplantation; LT, Liver transplantation; MELD, Model for End-stage Liver Disease\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding source\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was supported by the Basic Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science and ICT (NRF-2022R1F1A1074375).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Institutional Review Board (IRB No.\u0026nbsp;2022-08-101-001) of Samsung Medical Center.\u003c/p\u003e\n\u003cp\u003eInformed consent was acquired from the recipients or their parents or legal guardians who were enrolled prospectively after approval of the institutional review board of Samsung Medical Center. The research was performed in accordance with relevant guidelines/regulations which were in accordance with the Declaration of Helsinki. Both the recipients and donors were not related to procurement from prisoners.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll the authors named have read and given their approval for the manuscript. We certify that the sequence in which the authors are listed in the manuscript has received unanimous consent from all involved.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare conflict of interest in that the protocol for producing the 3-D printed intra-abdominal cavity model is under the process of patent registration in Republic of Korea.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eS.P. and J.R. developed the research idea and participated in the study design and writing of the paper. S.P., J.R., G.C., J.M.K., S.L and J.J. participated in data acquisition and interpretation. S.P. and J.R. participated in statistical analysis. Each author contributed important intellectual content during manuscript drafting. J.R. provided supervision.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBurra P, Burroughs A, Graziadei I, Pirenne J, Valdecasas JC, Muiesan P, Samuel D, Forns X: \u003cstrong\u003eEASL clinical practice guidelines: liver transplantation\u003c/strong\u003e. \u003cem\u003eJournal of hepatology \u003c/em\u003e2016, \u003cstrong\u003e64\u003c/strong\u003e(2):433-485.\u003c/li\u003e\n\u003cli\u003eFukazawa K, Nishida S: \u003cstrong\u003eSize mismatch in liver transplantation\u003c/strong\u003e. \u003cem\u003eJournal of Hepato‐Biliary‐Pancreatic Sciences \u003c/em\u003e2016, \u003cstrong\u003e23\u003c/strong\u003e(8):457-466.\u003c/li\u003e\n\u003cli\u003eUrata K, Kawasaki S, Matsunami H, Hashikura Y, Ikegami T, Ishizone S, Momose Y, Komiyama A, Makuuchi M: \u003cstrong\u003eCalculation of child and adult standard liver volume for liver transplantation\u003c/strong\u003e. \u003cem\u003eHepatology \u003c/em\u003e1995, 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living donor liver transplantation\u003c/strong\u003e. \u003cem\u003eLiver transplantation \u003c/em\u003e2013, \u003cstrong\u003e19\u003c/strong\u003e(12):1304-1310.\u003c/li\u003e\n\u003cli\u003ePark S, Choi G-S, Kim JM, Lee S, Joh J-W, Rhu J: \u003cstrong\u003e3D printing model of abdominal cavity of liver transplantation recipient to prevent large-for-size syndrome\u003c/strong\u003e. \u003cem\u003eInt J Bioprint \u003c/em\u003e2022.\u003c/li\u003e\n\u003cli\u003eFukazawa K, Nishida S, Pretto EA, Jr., Vater Y, Reyes JD: \u003cstrong\u003eDetrimental graft survival of size-mismatched graft for high model for end-stage liver disease recipients in liver transplantation\u003c/strong\u003e. \u003cem\u003eJ Hepatobiliary Pancreat Sci \u003c/em\u003e2016, \u003cstrong\u003e23\u003c/strong\u003e(7):406-413.\u003c/li\u003e\n\u003cli\u003eAddeo P, Noblet V, Naegel B, Bachellier P: \u003cstrong\u003eLarge-for-size orthotopic liver transplantation: a systematic review of definitions, outcomes, and solutions\u003c/strong\u003e. \u003cem\u003eJournal of Gastrointestinal Surgery \u003c/em\u003e2020, \u003cstrong\u003e24\u003c/strong\u003e(5):1192-1200.\u003c/li\u003e\n\u003cli\u003eAllard MA, Lopes F, Frosio F, Golse N, Sa Cunha A, Cherqui D, Castaing D, Adam R, Vibert E: \u003cstrong\u003eExtreme large-for-size syndrome after adult liver transplantation: A model for predicting a potentially lethal complication\u003c/strong\u003e. \u003cem\u003eLiver Transpl \u003c/em\u003e2017, \u003cstrong\u003e23\u003c/strong\u003e(10):1294-1304.\u003c/li\u003e\n\u003cli\u003eMarconi S, Pugliese L, Botti M, Peri A, Cavazzi E, Latteri S, Auricchio F, Pietrabissa A: \u003cstrong\u003eValue of 3D printing for the comprehension of surgical anatomy\u003c/strong\u003e. \u003cem\u003eSurg Endosc \u003c/em\u003e2017, \u003cstrong\u003e31\u003c/strong\u003e(10):4102-4110.\u003c/li\u003e\n\u003cli\u003eOshiro Y, Mitani J, Okada T, Ohkohchi N: \u003cstrong\u003eA novel three-dimensional print of liver vessels and tumors in hepatectomy\u003c/strong\u003e. \u003cem\u003eSurgery today \u003c/em\u003e2017, \u003cstrong\u003e47\u003c/strong\u003e(4):521-524.\u003c/li\u003e\n\u003cli\u003eRhu J, Kim MS, Kim S, Choi G-S, Kim JM, Joh J-W: \u003cstrong\u003eApplication of three-dimensional printing for intraoperative guidance during liver resection of a hepatocellular carcinoma with sophisticated location\u003c/strong\u003e. \u003cem\u003eAnnals of Hepato-biliary-pancreatic Surgery \u003c/em\u003e2021, \u003cstrong\u003e25\u003c/strong\u003e(2):265.\u003c/li\u003e\n\u003cli\u003eIkegami T, Maehara Y: \u003cstrong\u003e3D printing of the liver in living donor liver transplantation\u003c/strong\u003e. \u003cem\u003eNature Reviews Gastroenterology \u0026amp; Hepatology \u003c/em\u003e2013, \u003cstrong\u003e10\u003c/strong\u003e(12):697-698.\u003c/li\u003e\n\u003cli\u003eWang P, Que W, Zhang M, Dai X, Yu K, Wang C, Peng Z, Zhong L: \u003cstrong\u003eApplication of 3‐Dimensional Printing in Pediatric Living Donor Liver Transplantation: A Single‐Center Experience\u003c/strong\u003e. \u003cem\u003eLiver Transplantation \u003c/em\u003e2019, \u003cstrong\u003e25\u003c/strong\u003e(6):831-840.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"3-D printing, liver transplantation, graft survival, donor selection","lastPublishedDoi":"10.21203/rs.3.rs-4157626/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4157626/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eIn liver transplantation (LT), large-for-size syndrome is not common but can result in fatal outcome. To prevent such fatal outcome, we manufactured 3-D printed intra-abdominal cavity to give intuitive understanding of the sizes of the graft and patient\u0026rsquo;s abdomen in patients with small body size between July 2020 to February 2022.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eClinical outcomes were compared between patients using our 3-D model during LT and patients who underwent LT without 3-D model by using 1:5 ratio propensity score-matched analysis.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAfter matching, total 20 patients using 3-D printed abdominal cavity model and 100 patients of control group were included in this study. There were no significant differences in 30-day postoperative complication (50.0% vs 64.0%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.356) and the incidence of large-for-size syndrome (0% vs 7%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.599). Overall survival of 3-D printed group was similar to the control group (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.665) but graft survival was significantly superior in 3-D printed group than the control group (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.034).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eSince it showed better graft survival as well as low cost and short production time, our 3-D printing protocol can be a feasible option for patients with small abdominal cavity to prevent large-for-size syndrome after LT.\u003c/p\u003e","manuscriptTitle":"Improved graft survival by using three-dimensional printing of intra- abdominal cavity to prevent large-for-size syndrome in liver transplantation","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-03 17:22:32","doi":"10.21203/rs.3.rs-4157626/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"7fde8c1d-8e25-4073-9359-d3eaf433b585","owner":[],"postedDate":"April 3rd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-04-03T17:23:09+00:00","versionOfRecord":{"articleIdentity":"rs-4157626","link":"https://doi.org/10.14701/ahbps.2023S1.OP-4-2","journal":{"identity":"annals-of-hepatobiliarypancreatic-surgery","isVorOnly":true,"title":"Annals of Hepato-Biliary-Pancreatic Surgery"},"publishedOn":"2023-06-08 17:23:09","publishedOnDateReadable":"June 8th, 2023"},"versionCreatedAt":"2024-04-03 17:22:32","video":"","vorDoi":"10.14701/ahbps.2023S1.OP-4-2","vorDoiUrl":"https://doi.org/10.14701/ahbps.2023S1.OP-4-2","workflowStages":[]},"version":"v1","identity":"rs-4157626","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4157626","identity":"rs-4157626","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}