| ISSN |
1948-5182 (online) |
| Open Access |
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
| Copyright |
© The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. |
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| Publisher |
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA |
| Website |
http://www.wjgnet.com |
| Category |
Gastroenterology & Hepatology |
| Manuscript Type |
Retrospective Cohort Study |
| Article Title |
Small for size syndrome difficult dilemma: Lessons from 10 years single centre experience in living donor liver transplantation
|
| Manuscript Source |
Invited Manuscript |
| All Author List |
Hany Shoreem, Emad Hamdy Gad, Hosam Soliman, Osama Hegazy, Sherif Saleh, Hazem Zakaria, Eslam Ayoub, Yasmin Kamel, Kalid Abouelella, Tarek Ibrahim and Ibrahim Marawan |
| Funding Agency and Grant Number |
|
| Corresponding Author |
Emad Hamdy Gad, MD, Lecturer of Hepatobiliary and Liver Transplantation Surgery, Hepatobiliary Surgery Department, National Liver Institute, Menoufiya University, 77 Algala albahary Street, Mansour Building, Shibin El-Koum 32817, Egypt. emad.gad1@liver.menofia.edu.eg |
| Key Words |
Living donor liver transplantation; Outcome after living donor liver transplantation; Small for size syndrome; Small for size graft; Portal inflow; Venous outflow |
| Core Tip |
Small for size syndrome (SFSS) was diagnosed in 20 (11.5%) of our recipients where, small for size dysfunction affected 16 of patients (80%) and small for size non function was present in four patients (20%). Regarding graft size in patients with SFSS; 10, 5 and 5 of patients had extra-small graft [small for size graft (SFSG), graft recipient weight ratio (GRWR) < 0.8], small graft (GRWR ≥ 0.8 and < 1) and medium sized graft (GRWR ≥ 1) respectively. Extra small graft (SFSG), portal hyper-perfusion, severe portal hypertension (PHTN), and venous outflow obstruction were the main direct causes of SFSS in 10 (50%), 3 (15%), 4 (20%), and 3 (15%) of patients respectively. While extra-small graft, PHTN, steatosis and left lobe graft were significant predictors of SFSS in univariate analysis, only graft size was independent predictor of SFSS on multivariate analysis. On the other hand, there was non-significant lower incidence of SFSS in patients with SFSG when splenectomy was done, furthermore, there was non-significant lower incidence of the syndrome in patients with right lobe graft when drainage of the right anterior and/or posterior liver sectors by middle hepatic vein, V5, V8, and/or right inferior vein was done. The SFSS related mortalities were recorded in 13/20 of patients (65%). The 6-mo, 1-, 3-, 5-, 7- and 10-year survival in patients with SFSS were 30%, 30%, 25%, 25%, 25% and 25% respectively, while, the 6-mo, 1-, 3-, 5-, 7- and 10-year survival in patients without SFSS were 70.1%, 65.6%, 61.7%, 61%, 59.7%, and 59.7% respectively, with statistical significant difference. |
| Publish Date |
2017-07-25 10:25 |
| Citation |
Shoreem H, Gad EH, Soliman H, Hegazy O, Saleh S, Zakaria H, Ayoub E, Kamel Y, Abouelella K, Ibrahim T, Marawan I. Small for size syndrome difficult dilemma: Lessons from 10 years single centre experience in living donor liver transplantation. World J Hepatol 2017; 9(21): 930-944 |
| URL |
http://www.wjgnet.com/1948-5182/full/v9/i21/930.htm |
| DOI |
http://dx.doi.org/10.4254/wjh.v9.i21.930 |
