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A Novel Method for the Prevention and Treatment of Small-for-Size Syndrome in Liver Transplantation.

Abstract：

BACKGROUND:Currently there is no consensus on the optimal management of small-for-size syndrome following liver transplantation. Here we describe a technique to alleviate portal hypertension and improve the hepatocyte reperfusion in small-for-size liver transplantation in a Lewis rat model. METHODS:The rats underwent trans-portal vein intra-hepatic portosystemic shunt using a self-developed porous conical tube (TPIPSS: Fig. 1) on small-for-size liver transplants (SFS) with right lobe graft. The treatment effect was evaluated by comparing hemodynamic parameters, morphological changes, serum parameters, ET-1 and eNOS expression, hepatocyte proliferation and apoptosis, CYP3A2 levels, postoperative complications, and survival between the two groups with SFS liver transplants. RESULTS:Porous conical prosthesis prolonged the filling time of small-for-size grafts. Moreover, grafts with TPIPSS showed a lower portal vein pressure, improved microcirculatory flow, alleviated histological changes, decreased ET-1 and increased eNOS expressions, and significantly less damage to liver function comparing to grafts without TPIPSS. Mean survival and overall 30-day survival were significantly higher in the TPIPSS group. CONCLUSIONS:These results demonstrate that porous conical tube as trans-portal vein intra-hepatic portosystemic shunt device is an effective way to alleviate portal vein hypertension and improve hepatocyte reperfusion after small-for-size liver transplantation.

journal_name

Dig Dis Sci

journal_title

Digestive diseases and sciences

authors

Feng Y,Han Z,Gu B,Li X,Wang B,Guo F,Praseedom RK,Wang F,Cheng H,Lucas A,Li Y,Chen H

doi

10.1007/s10620-020-06055-2

subject

Has Abstract

pub_date

2020-09-01 00:00:00

pages

2619-2629

issue

9

eissn

0163-2116

issn

1573-2568

pii

10.1007/s10620-020-06055-2

journal_volume

65

pub_type

杂志文章

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