Abstract：
BACKGROUND: The small-for-size syndrome (SFSS) is characterized by prolonged hyperbilirubinemia, coagulopathy, and/or encephalopathy caused by a small liver graft that cannot sustain the metabolic demands of the recipient after a partial liver transplant (PLT). Models of PLT in pigs are excellent for studying this syndrome. This review aimed to identify the different porcine models of SFSS in the literature and compare their technical aspects and therapeutics methods focused on portal inflow modulation (PIM).
METHODS: We performed a systematic review of the porcine experimental model and SFSS. The MEDLINE-PubMed, EMBASE, Cochrane Library, LILACS, and SciELO databases were electronically searched and updated until June 20, 2021. The MeSH terms used were \'\'ORGAN SIZE\'\' AND \'\'LIVER TRANSPLANTATION\".
RESULTS: Thirteen SFSS porcine models were reported. Four were performed with portocaval shunt to PIM and 3 with mesocaval shunt to PIM. A few studies focused on clinical therapeutics to PIM; a study described somatostatin infusion to avoid SFSS. Initially, studies on PIM showed its potentially beneficial effects without mentioning the minimum portal flow that permits liver regeneration. However, an excessive portal diversion could be detrimental to this process.
CONCLUSIONS: The use of porcine models on SFSS resulted in a better understanding of its pathophysiology and led to the establishment of various types of portal modulation, surgical techniques with different complexities, and pharmaceutical strategies such as somatostatin, making clear that without reducing the portal vein pressure the outcomes are poor. With the improvement of these techniques, SFSS can be avoided.
METHODS: We performed a systematic review of the porcine experimental model and SFSS. The MEDLINE-PubMed, EMBASE, Cochrane Library, LILACS, and SciELO databases were electronically searched and updated until June 20, 2021. The MeSH terms used were \'\'ORGAN SIZE\'\' AND \'\'LIVER TRANSPLANTATION\".
RESULTS: Thirteen SFSS porcine models were reported. Four were performed with portocaval shunt to PIM and 3 with mesocaval shunt to PIM. A few studies focused on clinical therapeutics to PIM; a study described somatostatin infusion to avoid SFSS. Initially, studies on PIM showed its potentially beneficial effects without mentioning the minimum portal flow that permits liver regeneration. However, an excessive portal diversion could be detrimental to this process.
CONCLUSIONS: The use of porcine models on SFSS resulted in a better understanding of its pathophysiology and led to the establishment of various types of portal modulation, surgical techniques with different complexities, and pharmaceutical strategies such as somatostatin, making clear that without reducing the portal vein pressure the outcomes are poor. With the improvement of these techniques, SFSS can be avoided.
摘要：
背景：小型综合征（SFSS）的特征是长期的高胆红素血症，凝血病,和/或由部分肝移植（PLT）后无法维持受体代谢需求的小肝移植引起的脑病。猪的PLT模型对于研究该综合征是极好的。这篇综述旨在确定文献中SFSS的不同猪模型，并比较它们的技术方面和治疗方法，重点是门静脉流入调节（PIM）。
方法：我们对猪实验模型和SFSS进行了系统评价。MEDLINE-PubMed,EMBASE,科克伦图书馆,LILACS,和SciELO数据库进行了电子搜索和更新，直到2021年6月20日。使用的MeSH术语是\'\'器官大小\'\'和\'\'肝移植\'。
结果：报道了13个SFSS猪模型。其中4例采用门腔静脉分流至PIM，3例采用中腔分流至PIM。一些研究集中在PIM的临床治疗上；一项研究描述了生长抑素输注以避免SFSS。最初，对PIM的研究显示了其潜在的有益作用，而没有提及允许肝脏再生的最小门静脉流量。然而,过度的门户转移可能对这一过程有害。
结论：在SFSS上使用猪模型可以更好地了解其病理生理学，并导致建立各种类型的门静脉调制，具有不同复杂性的手术技术，和药物策略，如生长抑素，明确指出，在不降低门静脉压力的情况下，结果很差。随着这些技术的改进，可以避免SFSS。
方法：我们对猪实验模型和SFSS进行了系统评价。MEDLINE-PubMed,EMBASE,科克伦图书馆,LILACS,和SciELO数据库进行了电子搜索和更新，直到2021年6月20日。使用的MeSH术语是\'\'器官大小\'\'和\'\'肝移植\'。
结果：报道了13个SFSS猪模型。其中4例采用门腔静脉分流至PIM，3例采用中腔分流至PIM。一些研究集中在PIM的临床治疗上；一项研究描述了生长抑素输注以避免SFSS。最初，对PIM的研究显示了其潜在的有益作用，而没有提及允许肝脏再生的最小门静脉流量。然而,过度的门户转移可能对这一过程有害。
结论：在SFSS上使用猪模型可以更好地了解其病理生理学，并导致建立各种类型的门静脉调制，具有不同复杂性的手术技术，和药物策略，如生长抑素，明确指出，在不降低门静脉压力的情况下，结果很差。随着这些技术的改进，可以避免SFSS。
