Living donor liver transplantation in small-for-size setting

Ikegami T., BALCI D., Jung D., Kim J. M., Quintini C.

INTERNATIONAL JOURNAL OF SURGERY, vol.82, pp.134-137, 2020 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Review
  • Volume: 82
  • Publication Date: 2020
  • Doi Number: 10.1016/j.ijsu.2020.07.003
  • Journal Name: INTERNATIONAL JOURNAL OF SURGERY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
  • Page Numbers: pp.134-137
  • Keywords: Living Donor Liver Transplantation, Small-for-Size Syndrome, Portal Vein Flow Modulation, Graft Inflow Modulation, SPLENIC ARTERY LIGATION, RECIPIENT WEIGHT RATIO, SINGLE-CENTER, GRAFT SIZE, SPLENECTOMY, MODULATION, REGENERATION, IMPACT, SAFETY, COMPLICATIONS
  • Ankara University Affiliated: Yes

Abstract

Small-for-Size Syndrome (SFSS) is one of the most feared complication of adult split liver and living donor liver transplantation. SFSS stems from a disproportionate/excessive portal vein flow relative to the volume of the implanted liver graft, and is currently one of the major practical limits to partial liver grafts' transplantation. In the last few decades many graft inflow modulation (GIM) techniques have been proposed to curtail the portal vein flow, allowing for successful transplantation of small partial liver grafts. Graft inflow modulation techniques span from Splenic Artery Ligation (SAL), to Splenectomy, Porto-Systemic Shunts and the lately proposed Splenic Devascularization. A patient tailored approach balancing the risk of SFSS with GIM specific morbidity, is more important than identifying the ideal GIM technique. Here we summarize the most recently published data to provide general indications in the challenging preoperative choice of a GIM techniques.