title: End-to-side portocaval shunting for a small-for-size graft in living donor liver transplantation.
abstract: In the development of adult-to-adult living donor liver transplantation (LDLT), the small-for-size graft has been associated with poor clinical outcome. Persistent portal hypertension or portal venous overperfusion are considered to be causative factors, and partial diversion of portal flow to systemic circulation may be effective for avoiding injuries that occur in the small-for-size (SFS) graft. Recently, we constructed an end-to-side portocaval shunting using 1 of the portal branches and anastomosed the other branch with the portal vein of the graft in 2 cases of LDLT recipients transplanted with a SFS graft. With the suppression of portal hypertension, as well as sufficient portal flow to the graft, the recipients recovered successfully with favorable graft function. This new and simple technique may be able to be used as a feasible and effective method to attenuate the SFS syndrome.
authors.affiliation: Department of Transplantation and Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan. takaday@kuhp.kyoto-u.ac.jp
authors.forename: Yasutsugu
authors.initials: Y
authors.lastname: Takada
authors.forename: Mikiko
authors.initials: M
authors.lastname: Ueda
authors.forename: Yukika
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujimoto
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyauchi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ogura
authors.forename: Takenori
authors.initials: T
authors.lastname: Ochiai
authors.forename: Koichi
authors.initials: K
authors.lastname: Tanaka
mesh_terms: D000293:Adolescent; D006801:Humans; D008099:Liver / Q000033:anatomy & histology*; D016031:Liver Transplantation / Q000379:methods; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011167:Portacaval Shunt, Surgical / Q000379:methods*; D016896:Treatment Outcome