Prevention strategies for small-for-size syndrome in adult-to-adult living-related liver transplantation:a report of 6 cases

Objective To explore the methods to prevent small-for-size syndrome(SFSS) in adult-to-adult living-related liver transplantation(A-A LDLT).Methods The clinical data of 6 cases of A-A LDLT performed in our hospital between February 2007 to October 2008 were retrospectively analyzed,including blood cell count,spleen thickness,diameter of portal vein in recipients before operation,graft recipient body weight ratio(GRWR),graft volume and standard liver volume ratio of receptor(GV/SLV),and hepatic vein reconstruction.ResultsOf the six grafts,the GV/SLV was more than 40%,the GRWR was always above 0.8% except one case was 0.74%.All the recipient grafts had good hepatic vein reconstruction,with no congestion in the grafts;of the six recipients no severe portal hypertension was observed,and no SFSS occurred in the six cases.Conclusions The occurrence of SFSS can be prevented by selecting the appropriate graft size,adequate venous blood drainage through hepatic veins,and control of the portal pressure.