Current concept of small-for-size grafts in living donor liver transplantation

Toru Ikegami, Mitsuo Shimada, Satoru Imura, Yusuke Arakawa, Akira Nii, Yuji Morine, Hirofumi Kanemura

Research output: Contribution to journalReview article

56 Citations (Scopus)

Abstract

The extended application of living donor liver transplantation (LDLT) has revealed the problem of graft size mismatching called "small-for-size (SFS) graft syndrome." The initial trials to resolve this problem involved increasing the procured graft size, from left to right, and even extension to include a right lobe graft. Clinical cases of living right lobe donations have been reported since then, drawing attention to the risks of increasing the liver volume procured from a living donor. However, not only other modes of increasing graft volume such as auxiliary or dual liver transplantation, but also control of the increased portal pressure caused by an SFS graft, such as a portosystemic shunt or splenectomy, have been trialed with some positive results. To establish an effective strategy for transplanting SFS grafts and preventing SFS graft syndrome, it is essential to have precise knowledge and tactics to evaluate graft quality and graft volume, when performing these LDLTs with portal pressure control. We reviewed the updated literature on the pathogenesis of and strategies for using SFS grafts.

Original languageEnglish
Pages (from-to)971-982
Number of pages12
JournalSurgery today
Volume38
Issue number11
DOIs
Publication statusPublished - Nov 1 2008
Externally publishedYes

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All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Ikegami, T., Shimada, M., Imura, S., Arakawa, Y., Nii, A., Morine, Y., & Kanemura, H. (2008). Current concept of small-for-size grafts in living donor liver transplantation. Surgery today, 38(11), 971-982. https://doi.org/10.1007/s00595-008-3771-1