Portal hyperperfusion injury as the cause of primary nonfunction in a small-for-size liver graft-successful treatment with splenic artery ligation.
Dysfunction of a small-for-size graft is an important clinical problem after living donor liver transplantation in adults. We report a case of primary nonfunction after a small-for-size right lobe living donor liver transplant that was successfully salvaged by reduction of portal pressure and blood flow after splenic artery ligation. The case established portal hyperperfusion injury as a cause of primary nonfunction in a small-for-size graft and we recommend that portal pressure be measured when clinical suspicion arises. Splenic artery ligation is a technically simple procedure that can be applied for the prevention or treatment of such injury.
Lo
Chung-Mau
CM
Department of Surgery, and Centre for the Study of Liver Disease, University of Hong Kong Medical Centre, Hong Kong. chungmlo@hkucc.hku.hk
Liu
Chi-Leung
CL
Fan
Sheung-Tat
ST
D000328:Adult; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D008026:Ligation; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D009929:Organ Size; D011168:Portal System / Q000503:physiopathology*; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D013157:Splenic Artery / Q000601:surgery*