Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

15 June 2022 : Original article  

[In Press] Graft Inflow Modulation in Living-Donor Liver Transplantation: Hepatic Hemodynamic Changes in Splenic Artery Ligation and Splenectomy

Che-Min Su1ABCDEF, Tsung-Ching Chou1ABD, Tsung-Han Yang1ABD, Yih-Jyh Lin1ABDEF

DOI: 10.12659/AOT.936609

Ann Transplant In Press; DOI: 10.12659/AOT.936609  

Available online: 2022-06-15, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule

Abstract

BACKGROUND
Excessive portal flow to an allograft was a key mechanism for small-for-size syndrome in living-donor liver transplantation (LDLT). Good outcomes in LDLT by graft inflow modulation (GIM) using a small graft were reported, but the effect on hepatic hemodynamics is undefined. This report summarizes our experience with GIM and compares the effects of splenic artery ligation (SAL) and splenectomy on hepatic hemodynamic changes.
MATERIAL AND METHODS
Ninety-nine patients who underwent adult-to-adult LDLT from June 2014 to December 2020 were included in this study. GIM was performed in 36 patients (17 patients with SAL and 19 with splenectomy).
RESULTS
The GIM group had lower graft-to-recipient weight compared to the no-modulation group (median, 0.91% versus 1.04%, P=0.022). Initial portal venous flow (PVF) was higher in the GIM group (median, 311 versus 156 ml/min/100 g, P<0.001). After GIM, PVF decreased to 224 ml/min/100 g. One-year graft survival with GIM was 89.9%, and for the no-modulation group it was 86.6% (P=0.945). In the subgroup analysis, the efficacy of decompressing PVF was higher in the splenectomy subgroup (median, 14.3% versus 41.8%, P=0.002).
CONCLUSIONS
GIM was useful for grafts with high PVF. Splenectomy modulated excessive PVF more effectively than did SAL. Perioperative hepatic hemodynamic changes could assist surgeons in selecting different GIM strategies.

Keywords: Hypertension, Portal; Liver Transplantation; Splenectomy

SARS-CoV-2/COVID-19

17 June 2022 : Case report  

Extrapulmonary Manifestations of SARS-CoV-2: A Report of 3 Cases and a Literature Review

Ann Transplant In Press; DOI: 10.12659/AOT.935874  

12 April 2022 : Letter/Correspondence  

Pancreas Allograft Thrombosis as a Post-COVID-19 Complication in a Diabetic Patient After Pancreas Transpla...

Ann Transplant 2022; 27:e935863

12 November 2021 : Original article  

Coronavirus Disease 2019 (COVID-19) in Solid Organ Transplant Recipients: A Case-Control Study

Ann Transplant 2021; 26:e933152

26 October 2021 : Original article  

Safety of Antithymocyte Globulin Use in Kidney Graft Recipients During the COVID-19 Pandemic

Ann Transplant 2021; 26:e933001

In Press

23 Jun 2022 : Original article  

Evaluation of Deceased Donor Kidney Transplantation in the Eurotransplant Senior Program in Comparison to S...

Ann Transplant In Press; DOI: 10.12659/AOT.936514  

21 Jun 2022 : Case report  

Extrapulmonary Manifestations of SARS-CoV-2: A Report of 3 Cases and a Literature Review

Ann Transplant In Press; DOI: 10.12659/AOT.935874  

20 Jun 2022 : Original article  

The Association Between Tacrolimus Levels and Hyperkalemia in Allograft Recipients Who Underwent Heart or L...

Ann Transplant In Press; DOI: 10.12659/AOT.935607  

15 Jun 2022 : Original article  

Donor CYP3A5 Expression Decreases Renal Transplantation Outcomes in White Renal Transplant Recipients

Ann Transplant In Press; DOI: 10.12659/AOT.936276  

Most Viewed Current Articles

26 Jan 2022 : Review article  

Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models

DOI :10.12659/AOT.934924

Ann Transplant 2022; 27:e934924

29 Dec 2021 : Original article  

Efficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...

DOI :10.12659/AOT.933588

Ann Transplant 2021; 26:e933588

24 Jul 2020 : Review article  

Kidney Transplantation in the Times of COVID-19 – A Literature Review

DOI :10.12659/AOT.925755

Ann Transplant 2020; 25:e925755

15 Mar 2022 : Case report  

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358