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End‐to‐side portocaval shunting for a small‐for‐size graft in living donor liver transplantation
Author(s) -
Takada Yasutsugu,
Ueda Mikiko,
Ishikawa Yukika,
Fujimoto Yasuhiro,
Miyauchi Hideaki,
Ogura Yasuhiro,
Ochiai Takenori,
Tanaka Koichi
Publication year - 2004
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.20164
Subject(s) - medicine , portal hypertension , liver transplantation , shunting , surgery , living donor liver transplantation , portal vein , liver function , transplantation , portal venous pressure , cirrhosis
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. (Liver Transpl 2004;10:807–810.)