title: Effect of mesocaval shunt on survival of small-for-size liver grafts: experimental study in pigs.
abstract: Segmental liver grafts with a calculated ideal liver weight (CILW) less than 40% may be associated with portal flow-related injuries and primary dysfunction. This study evaluated the effect of mesocaval shunts on the survival of grafts with a CILW less than 20%. Sixteen pigs underwent orthotopic transplantation of segmental liver grafts with a CILW less than 20%. In eight animals (study group), transplantation was combined with a mesocaval shunt, and eight animals served as controls without a mesocaval shunt. Liver function, systemic hemodynamics, portal vein pressure, intracranial pressure, and cerebral perfusion pressure were assessed postoperatively. The controls showed a rapid impairment of liver function reflected by a significant elevation in aspartate aminotransferase, international normalized ratio, bilirubin, and intracranial pressure and a decrease in cerebral perfusion pressure compared with the study group (P<0.05). Mesocaval shunts showed protective effects on grafts with CILW less than 20% and may have a clinical role in the salvage of small-for-size liver grafts.
authors.affiliation: Second Department of Surgery, University of Athens Medical School, Aretaieion Hospital, Athens, Greece.
authors.forename: Vassilios E
authors.initials: VE
authors.lastname: Smyrniotis
authors.forename: Georgia
authors.initials: G
authors.lastname: Kostopanagiotou
authors.forename: Kassiani
authors.initials: K
authors.lastname: Theodoraki
authors.forename: Evangelos
authors.initials: E
authors.lastname: Gamaletsos
authors.forename: Agathi
authors.initials: A
authors.lastname: Kondi-Pafiti
authors.forename: Kyriaki
authors.initials: K
authors.lastname: Mystakidou
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Arkadopoulos
mesh_terms: D000818:Animals; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D001794:Blood Pressure; D002560:Cerebrovascular Circulation; D006085:Graft Survival; D006439:Hemodynamics; D007427:Intracranial Pressure; D008099:Liver / Q000033:anatomy & histology* / Q000473:pathology / Q000503:physiopathology; D008107:Liver Diseases / Q000209:etiology; D016031:Liver Transplantation / Q000009:adverse effects; D009929:Organ Size; D011170:Portasystemic Shunt, Surgical; D011184:Postoperative Period; D013552:Swine
chemical_list: D001219:Aspartate Aminotransferases; D001663:Bilirubin