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

dc.authorid109262en_US
dc.contributor.authorKayaalp, Cüneyt
dc.contributor.authorKınacı, Erdem
dc.date.accessioned2017-09-12T07:53:03Z
dc.date.available2017-09-12T07:53:03Z
dc.date.issued2016
dc.departmentİnönü Üniversitesien_US
dc.description.abstractBackground 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.en_US
dc.identifier.citationKayaalp, 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.en_US
dc.identifier.doi10.1007/s00268-016-3518-xen_US
dc.identifier.endpage1940en_US
dc.identifier.issue8en_US
dc.identifier.startpage1932en_US
dc.identifier.urihttps://hdl.handle.net/11616/7752
dc.identifier.volume40en_US
dc.language.isoenen_US
dc.publisherWorld journal of surgeryen_US
dc.relation.ispartofWorld journal of surgeryen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.titlePortosystemic shunts for too small for size syndrome after liver transplantation A systematic reviewen_US
dc.typeArticleen_US

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