Living donor liver transplantation in small-for-size setting

Toru Ikegami, Deniz Balci, Dong Hwan Jung, Jong Man Kim, Cristiano Quintini

Research output: Contribution to journalReview article

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.

Original languageEnglish
JournalInternational Journal of Surgery
DOIs
Publication statusAccepted/In press - 2020

All Science Journal Classification (ASJC) codes

  • Surgery

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