title: Small-for-size syndrome in living donor liver transplantation.
abstract: When the graft volume is too small to satisfy the recipient's metabolic demand, the recipient may thus experience small-for-size syndrome (SFSS). Because the occurrence of SFSS is determined by not only the liver graft volume but also a combination of multiple negative factors, the definitions of small-for-size graft (SFSG) and SFSS are different in each institute and at each time. In the clinical setting, surgical inflow modulation and maximizing the graft outflow are keys to overcoming SFSS. Accordingly, relatively smaller-sized grafts can be used with surgical modification and pharmacological manipulation targeting portal circulation and liver graft quality. Therefore, the focus of the SFSG issue is now shifting from how to obtain a larger graft from the living donor to how to manage the use of a smaller graft to save the recipient, considering donor safety to be a priority.
authors.affiliation: Department of Hepatobiliary, Pancreas and Transplant Surgery, Kyoto University Graduate School of Medicine, 54 Kawara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan. shintaro@kuhp.kyoto-u.ac.jp
authors.forename: Shintaro
authors.initials: S
authors.lastname: Yagi
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
mesh_terms: D001201:Ascites / Q000209:etiology*; D001835:Body Weight; D002779:Cholestasis / Q000209:etiology*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D008099:Liver / Q000033:anatomy & histology* / Q000503:physiopathology*; D008115:Liver Regeneration; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D009929:Organ Size; D011517:Prothrombin Time; D012307:Risk Factors; D013577:Syndrome