title: Small-for-size syndrome secondary to outflow block of the segments V and VIII anastomoses--successful treatment with trans-splenic artery embolization: a case report.
abstract: Despite the rapid expansion of living donor liver transplantation (LDLT) in the adult population over the last few years, small-for-size syndrome (SFSS) has emerged as an important clinical problem. We have herein reported a patient who developed clinical evidence of prolonged cholestasis and intractable ascites after a small-for-size right lobe LDLT. The SFSS was attributed to outflow block of segments V and VIII anastomoses with severe portal overperfusion injury. It was successfully treated by reduction of portal pressure and blood flow after trans-splenic arterial ligation. We recommend that trans-splenic artery embolization, a technically simple procedure, be applied to treat portal overperfusion injury in SFSS.
authors.affiliation: Liver Transplantation Division, Department of Surgery, West China Hospital, Sichuan University Medical School, Chengdu, China 610041. yanlunan688@163.com
authors.forename: L
authors.initials: L
authors.lastname: Yan
authors.forename: W
authors.initials: W
authors.lastname: Wang
authors.forename: Z
authors.initials: Z
authors.lastname: Chen
authors.forename: W
authors.initials: W
authors.lastname: Lu
authors.forename: Q
authors.initials: Q
authors.lastname: Lu
authors.forename: W
authors.initials: W
authors.lastname: Cheng
authors.forename: T
authors.initials: T
authors.lastname: Wen
authors.forename: M
authors.initials: M
authors.lastname: Xu
authors.forename: J
authors.initials: J
authors.lastname: Yang
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects*; D021721:Balloon Occlusion; D006801:Humans; D008099:Liver / Q000033:anatomy & histology*; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D013154:Spleen / Q000098:blood supply*; D013577:Syndrome