Portosystemic shunts for too small for size syndrome after liver transplantation A systematic review

Yükleniyor...
Küçük Resim

Tarih

2016

Dergi Başlığı

Dergi ISSN

Cilt Başlığı

Yayıncı

World journal of surgery

Erişim Hakkı

info:eu-repo/semantics/openAccess

Özet

Background Portosystemic shunts (PSSs) modulate the portal hyperperfusion against small-for-size syndrome (SFSS) after split or living donor liver transplantation. Aim To find out the results and the limitations of PSSs against SFSS. Materials and methods We searched PubMed and Cochrane databanks for systematic review and analyzed the indications, types, morbidities, and survivals of the PSSs at split or living donor liver transplantations. Results Total 66 patients were assessed in 16 studies. Main indications for PSS were graft recipient weight ratio (GRWRs) \0.8 % and/or portal vein pressure [20 mmHg. Five different types of PSSs were described but hemiportocaval shunts were the most common one. The incidence of SFSS was 12 %. Overall 90-day, 1-, and 3-year graft survivals were 80, 70, and 47 %, respectively. GRWR\0.65 % was found as the only significant parameter on graft survival. The 90-day, 1- and 3-year graft survivals for GRWR\0.65 and C0.65 % patients were 62.5, 42.8, and 30.0 and 95, 94, and 67 %, respectively (p = 0.03, p = 0.01, and p = 0.18). Conclusion PSSs can modulate the small graft size (GRWR \0.8 %) and/or portal hypertension ([20 mmHg) after split or living donor liver transplantations sufficiently. However, its protective effect is not unlimited. If the GRWR is below 0.65 %, survival decreases significantly despite PSSs.

Açıklama

Anahtar Kelimeler

Kaynak

World journal of surgery

WoS Q Değeri

Scopus Q Değeri

Cilt

40

Sayı

8

Künye

Kayaalp, C. Kınacı, E. (2016). Portosystemic shunts for too small for size syndrome after liver transplantation A systematic review. World journal of surgery. 40,8, 1932–1940.