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Small-for-size syndrome after partial liver transplantation: definition, mechanisms of disease and clinical implications.
Journal article

Small-for-size syndrome after partial liver transplantation: definition, mechanisms of disease and clinical implications.

  • Dahm F Department of Visceral and Transplantation Surgery, University Hospital Zurich, Zurich, Switzerland.
  • Georgiev P
  • Clavien PA
  • 2005-10-11
Published in:
  • American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. - 2005
Body Constitution
Cadaver
Hepatectomy
Humans
Liver
Liver Circulation
Liver Regeneration
Liver Transplantation
Patient Selection
Tissue Donors
Tissue and Organ Harvesting
English Widespread application of cadaveric split or living donor liver transplantation bears considerable potential to increase the pool of available organs and thus alleviate the problem of organ shortage. Although splitting of a cadaveric liver into two grafts for adult recipients can be performed successfully, sufficient function of undersized grafts is a major concern. To minimize the risk for living donors, transplant surgeons aim at procuring the least necessary liver volume, also leading to potentially small grafts. When small partial grafts are unable to meet the functional demands, the recipients can develop a so-called small-for-size syndrome (SFSS). There is currently limited data on the pathogenesis of SFSS, with clinical studies mainly focusing on portal hyperperfusion. Additional aspects include graft-related factors such as functional and regenerative capacity, as well as recipient-related factors, such as overall health status and severity of cirrhosis. However, there is currently no consensus on the definition of SFSS. We propose a novel definition, based on simple clinical criteria, which divides the syndrome into either nonfunction or dysfunction of a small graft after the exclusion of other causes. This definition should ease comparability of future clinical trials, and thus improve understanding of the pathogenesis of SFSS.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://folia.unifr.ch/global/documents/57110
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