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World J Gastroenterol. Oct 28, 2010; 16(40): 5011-5015
Published online Oct 28, 2010. doi: 10.3748/wjg.v16.i40.5011
Published online Oct 28, 2010. doi: 10.3748/wjg.v16.i40.5011
Small-for-size syndrome in adult-to-adult living-related liver transplantation
Salvatore Gruttadauria, Duilio Pagano, Angelo Luca, Bruno Gridelli, Istituto Mediterraneo Trapianti e Terapie ad Alta Specializzazione, University of Pittsburgh Medical Center in Italy, Palermo 90127, Italy
Salvatore Gruttadauria, Bruno Gridelli, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, United States
Author contributions: Gruttadauria S is based on drafting the article critically for important intellectual content; Gruttadauria S, Pagano D and Luca A gave substantial contributions to conception and design, acquisition of data, and interpretation of data; Gruttadauria S and Gridelli B gave the final approval of the version to be published.
Correspondence to: Salvatore Gruttadauria, MD, Associate Professor of Surgery, Istituto Mediterraneo Trapianti e Terapie ad Alta Specializzazione, University of Pittsburgh Medical Center in Italy, Palermo 90127, Italy. sgruttadauria@ismett.edu
Telephone: +39-9-12192111 Fax: +39-9-12192400
Received: July 6, 2010
Revised: July 30, 2010
Accepted: August 6, 2010
Published online: October 28, 2010
Revised: July 30, 2010
Accepted: August 6, 2010
Published online: October 28, 2010
Abstract
Small-for-size syndrome (SFSS) in adult-to-adult living-related donor liver transplantation (LRLT) remains the greatest limiting factor for the expansion of segmental liver transplantation from either cadaveric or living donors. Portal hyperperfusion, venous pathology, and the arterial buffer response significantly contribute to clinical and histopathological manifestations of SFSS. Here, we review the technical aspects of surgical and radiological procedures developed to treat SFSS in LRLT, along with the pathophysiology of this condition.
Keywords: Adult-to-adult living-related liver transplantation; Small-for-size syndrome; Liver resection; Liver transplantation