Premium
Does the Permanent Portacaval Shunt for a Small‐for‐Size Graft in a Living Donor Liver Transplantation Do More Harm Than Good?
Author(s) -
Oura T.,
Taniguchi M.,
Shimamura T.,
Suzuki T.,
Yamashita K.,
Uno M.,
Goto R.,
Watanabe M.,
Kamiyama T.,
Matsushita M.,
Furukawa H.,
Todo S.
Publication year - 2008
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2007.02045.x
Subject(s) - portacaval shunt , medicine , shunt (medical) , surgery , living donor liver transplantation , liver transplantation , atrophy , transplantation , liver function , portal hypertension , cirrhosis
In order to obviate a small‐for‐size graft syndrome (SFSGS), a portacaval (PC) shunt had been considered in a case of adult‐to‐adult living donor liver transplantation (AA‐LDLT). In a recent AA‐LDLT case, we adopted the PC shunt to resolve SFSGS; however, graft atrophy was observed in the late period of LDLT, thereby resulting in liver dysfunction. Due to the surgical closure of the PC shunt at 11 months post‐LDLT, the graft regenerated gradually and resulted in the recovery of the liver function. This experience indicates that the portacaval shunt would overcome SFSGS in the early period of LDLT, while it would cause the graft atrophy and the graft dysfunction in the late period of LDLT.