Extracorporeal continuous portal diversion plus temporal plasmapheresis for “small-for-size” syndrome

Figure 1 Flow diagram of the extracorporeal circuit indicating the plasmapheresis and conditions of slow plasma exchange. The portal venous blood was aspirated through the portal catheter and into tubing connected to a centrifugal pump immediately post-hepatectomy (PH), and then passed through plasma-separation cartridges with a blood flow of 90-110 mL/min. From 24 h PH these pigs were converted to plasma exchange for 6 h. After that the blood was returned to the pig through a double-lumen catheter inserted into the internal jugular or subclavian vein, and then continued on extracorporeal continuous portal diversion until 48 h PH. FFP: Fresh frozen plasma.