The short- and long-term outcomes in living-donor liver transplantation using small-for-size graft: A systematic review and meta-analysis

Kim, Ki‐Hun; Kim, Sang-Hoon; Cho, Hwui-Dong

doi:10.1016/j.trre.2023.100747

Cited by 5 publications

(2 citation statements)

References 40 publications

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“…3 There is increasing evidence to suggest that SFSS is a multifactorial syndrome, precipitated by various perioperative factors in a small-for-size graft (SFSG) setting. 4 The hemodynamic alterations which SFSG sustain following reperfusion damage the hepatocytes, affect sinusoidal endothelial integrity, and cause dampening of hepatic arterial buffer response leading to arterial hypoperfusion, and resultant ischemic injury to the graft. 3,5 The understanding and analysis of the several perioperative factors involved in the occurrence of SFSS, including donor and recipient selection, intraoperative and postoperative managements, are essential to prevent and manage SFSS (Figure 1).…”

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Preventing Small-for-size Syndrome in Living Donor Liver Transplantation: Guidelines From the ILTS-iLDLT-LTSI Consensus Conference

Hakeem,

Mathew,

Aunés

et al. 2023

Transplantation

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Small-for-size syndrome (SFSS) is a well-recognized complication following liver transplantation (LT), with up to 20% developing this following living donor LT (LDLT). Preventing SFSS involves consideration of factors before the surgical procedure, including donor and recipient selection, and factors during the surgical procedure, including adequate outflow reconstruction, graft portal inflow modulation, and management of portosystemic shunts. International Liver Transplantation Society, International Living Donor Liver Transplantation Group, and Liver Transplant Society of India Consensus Conference was convened in January 2023 to develop recommendations for the prediction and management of SFSS in LDLT. The format of the conference was based on the Grading of Recommendations, Assessment, Development, and Evaluation system. International experts in this field were allocated to 4 working groups (diagnosis, prevention, anesthesia, and critical care considerations, and management of established SFSS). The working groups prepared evidence-based recommendations to answer-specific questions considering the currently available literature. The working group members, independent panel, and conference attendees served as jury to edit and confirm the final recommendations presented at the end of the conference by each working group separately. This report presents the final statements and evidence-based recommendations provided by working group 2 that can be implemented to prevent SFSS in LDLT patients.

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