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Strategies for improving the outcomes of small-for-size grafts in adult-to-adult living-donor liver transplantation

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Journal of Hepato-Biliary-Pancreatic Surgery

Abstract

Living-donor liver transplantation (LDLT) has been refined and accepted as a valuable treatment for patients with end-stage liver disease in order to overcome the shortage of organs and mortality on the waiting list. However, graft size problems, especially small-for-size (SFS) grafts, remain the greatest limiting factor for the expansion of LDLT, especially in adult-to-adult transplantation. Various attempts have been made to overcome the problems regarding SFS grafts, such as increasing the graft liver volume and/or controlling excessive portal inflow to a small graft, with considerable positive outcomes. Recent innovations in basic studies have also contributed to the treatment of SFS syndrome. Herein, we review the literature and assess our current knowledge of the pathogenesis and treatment strategies for the use of SFS grafts in adult-to-adult LDLT.

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  1. Department of Surgery, Institute of Health Biosciences, The University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan

    Satoru Imura, Mitsuo Shimada, Toru Ikegami, Yuji Morine & Hirofumi Kanemura

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  1. Satoru Imura
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  2. Mitsuo Shimada
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  3. Toru Ikegami
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  5. Hirofumi Kanemura
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Imura, S., Shimada, M., Ikegami, T. et al. Strategies for improving the outcomes of small-for-size grafts in adult-to-adult living-donor liver transplantation. J Hepatobiliary Pancreat Surg 15, 102–110 (2008). https://doi.org/10.1007/s00534-007-1297-3

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