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- Publisher Website: 10.1097/TP.0000000000004770
- Scopus: eid_2-s2.0-85173884699
- PMID: 37749812
- WOS: WOS:001073523200002
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Article: Post Living Donor Liver Transplantation Small-for-size Syndrome: Definitions, Timelines, Biochemical, and Clinical Factors for Diagnosis: Guidelines from the ILTS-iLDLT-LTSI Consensus Conference
Title | Post Living Donor Liver Transplantation Small-for-size Syndrome: Definitions, Timelines, Biochemical, and Clinical Factors for Diagnosis: Guidelines from the ILTS-iLDLT-LTSI Consensus Conference |
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Authors | Kow, Alfred Wei ChiehLiu, JiangPatel, Madhukar S.De Martin, EleonoraReddy, Mettu SrinivasSoejima, YujiSyn, NicholasWatt, KymberlyXia, QiangSaraf, NeerajKamel, RefaatNasralla, DavidMcKenna, GregSrinvasan, ParthiElsabbagh, Ahmed M.Pamecha, VinayendraPalaniappan, KumarMas, ValeriaTokat, YamanAsthana, SonalCherukuru, RamkiranEgawa, HirotoLerut, JanBroering, DieterBerenguer, MarinaCattral, MarkClavien, Pierre AlainChen, Chao LongShah, SamirZhu, Zhi JunEmond, JeanAscher, NancyRammohan, AshwinBhangui, PrashantRela, MohamedKim, Dong SikIkegami, Toru |
Issue Date | 2023 |
Citation | Transplantation, 2023, v. 107, n. 10, p. 2226-2237 How to Cite? |
Abstract | Background. When a partial liver graft is unable to meet the demands of the recipient, a clinical phenomenon, small-for-size syndrome (SFSS), may ensue. Clear definition, diagnosis, and management are needed to optimize transplant outcomes. Methods. A Consensus Scientific committee (106 members from 21 countries) performed an extensive literature review on specific aspects of SFSS, recommendations underwent blinded review by an independent panel, and discussion/voting on the recommendations occurred at the Consensus Conference. Results. The ideal graft-to-recipient weight ratio of ≥0.8% (or graft volume standard liver volume ratio of ≥40%) is recommended. It is also recommended to measure portal pressure or portal blood flow during living donor liver transplantation and maintain a postreperfusion portal pressure of <15 mm Hg and/or portal blood flow of <250 mL/min/100 g graft weight to optimize outcomes. The typical time point to diagnose SFSS is the postoperative day 7 to facilitate treatment and intervention. An objective 3-grade stratification of severity for protocolized management of SFSS is proposed. Conclusions. The proposed grading system based on clinical and biochemical factors will help clinicians in the early identification of patients at risk of developing SFSS and institute timely therapeutic measures. The validity of this newly created grading system should be evaluated in future prospective studies. |
Persistent Identifier | http://hdl.handle.net/10722/342684 |
ISSN | 2021 Impact Factor: 5.385 2020 SCImago Journal Rankings: 1.450 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Kow, Alfred Wei Chieh | - |
dc.contributor.author | Liu, Jiang | - |
dc.contributor.author | Patel, Madhukar S. | - |
dc.contributor.author | De Martin, Eleonora | - |
dc.contributor.author | Reddy, Mettu Srinivas | - |
dc.contributor.author | Soejima, Yuji | - |
dc.contributor.author | Syn, Nicholas | - |
dc.contributor.author | Watt, Kymberly | - |
dc.contributor.author | Xia, Qiang | - |
dc.contributor.author | Saraf, Neeraj | - |
dc.contributor.author | Kamel, Refaat | - |
dc.contributor.author | Nasralla, David | - |
dc.contributor.author | McKenna, Greg | - |
dc.contributor.author | Srinvasan, Parthi | - |
dc.contributor.author | Elsabbagh, Ahmed M. | - |
dc.contributor.author | Pamecha, Vinayendra | - |
dc.contributor.author | Palaniappan, Kumar | - |
dc.contributor.author | Mas, Valeria | - |
dc.contributor.author | Tokat, Yaman | - |
dc.contributor.author | Asthana, Sonal | - |
dc.contributor.author | Cherukuru, Ramkiran | - |
dc.contributor.author | Egawa, Hiroto | - |
dc.contributor.author | Lerut, Jan | - |
dc.contributor.author | Broering, Dieter | - |
dc.contributor.author | Berenguer, Marina | - |
dc.contributor.author | Cattral, Mark | - |
dc.contributor.author | Clavien, Pierre Alain | - |
dc.contributor.author | Chen, Chao Long | - |
dc.contributor.author | Shah, Samir | - |
dc.contributor.author | Zhu, Zhi Jun | - |
dc.contributor.author | Emond, Jean | - |
dc.contributor.author | Ascher, Nancy | - |
dc.contributor.author | Rammohan, Ashwin | - |
dc.contributor.author | Bhangui, Prashant | - |
dc.contributor.author | Rela, Mohamed | - |
dc.contributor.author | Kim, Dong Sik | - |
dc.contributor.author | Ikegami, Toru | - |
dc.date.accessioned | 2024-04-17T07:05:31Z | - |
dc.date.available | 2024-04-17T07:05:31Z | - |
dc.date.issued | 2023 | - |
dc.identifier.citation | Transplantation, 2023, v. 107, n. 10, p. 2226-2237 | - |
dc.identifier.issn | 0041-1337 | - |
dc.identifier.uri | http://hdl.handle.net/10722/342684 | - |
dc.description.abstract | Background. When a partial liver graft is unable to meet the demands of the recipient, a clinical phenomenon, small-for-size syndrome (SFSS), may ensue. Clear definition, diagnosis, and management are needed to optimize transplant outcomes. Methods. A Consensus Scientific committee (106 members from 21 countries) performed an extensive literature review on specific aspects of SFSS, recommendations underwent blinded review by an independent panel, and discussion/voting on the recommendations occurred at the Consensus Conference. Results. The ideal graft-to-recipient weight ratio of ≥0.8% (or graft volume standard liver volume ratio of ≥40%) is recommended. It is also recommended to measure portal pressure or portal blood flow during living donor liver transplantation and maintain a postreperfusion portal pressure of <15 mm Hg and/or portal blood flow of <250 mL/min/100 g graft weight to optimize outcomes. The typical time point to diagnose SFSS is the postoperative day 7 to facilitate treatment and intervention. An objective 3-grade stratification of severity for protocolized management of SFSS is proposed. Conclusions. The proposed grading system based on clinical and biochemical factors will help clinicians in the early identification of patients at risk of developing SFSS and institute timely therapeutic measures. The validity of this newly created grading system should be evaluated in future prospective studies. | - |
dc.language | eng | - |
dc.relation.ispartof | Transplantation | - |
dc.title | Post Living Donor Liver Transplantation Small-for-size Syndrome: Definitions, Timelines, Biochemical, and Clinical Factors for Diagnosis: Guidelines from the ILTS-iLDLT-LTSI Consensus Conference | - |
dc.type | Article | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1097/TP.0000000000004770 | - |
dc.identifier.pmid | 37749812 | - |
dc.identifier.scopus | eid_2-s2.0-85173884699 | - |
dc.identifier.volume | 107 | - |
dc.identifier.issue | 10 | - |
dc.identifier.spage | 2226 | - |
dc.identifier.epage | 2237 | - |
dc.identifier.isi | WOS:001073523200002 | - |