Living donor liver transplantation with extra-small graft; inflow modulation using splenectomy and temporary portocaval shunt.

摘要: In living donor liver transplantation in adults, a strategy to manage unexpected small graft is essential. The patient was 47-year-old female with end-stage disease secondary hepatitis C hepatocellular carcinoma, and the 20-years-old female. Although estimated left lobe volume 379g 35.8% of standard recipient, actual just 250g, representing only 23% volume. After implantation this graft, splenectomy followed by end-to-side portocaval shut done, both for modulating excessive portal inflow graft. Despite excellent initial function hepatopetal flow an gold-colored bile from decreased regeneration 4 days after transplantation. So closure shunt carried out. Since then there good postoperative course without any sign syndrome. She discharged hospital at 21 This type modulation may allow us such extra-small However, careful post-transplant monitoring essential gaining acceptable outcome.