PDF(Pubmed)
Abstract：
Early series in living donor liver transplantation (LDLT) in adults demonstrated a lower safe limit of graft volume standard liver volume ratio 25%-45%. A subsequent worldwide large LDLT series proposed a 0.8 graft recipient weight ratio (GRWR) to define small-for-size graft (SFSG) in adult LDLT. Thereafter, researchers identified innate and inevitable factors including changes in liver volume during imaging studies and graft shrinkage due to perfusion solution. Although the definition of small-for-size syndrome (SFSS) advocated in the 2000s was mainly based on prolonged cholestasis and ascites output, the term SFSS was inadequate to describe clinical manifestations possibly caused by multiple factors. Thus, the term \"early allograft dysfunction (EAD),\" characterized by total bilirubin >10 mg/dL or coagulopathy with international normalized ratio >1.6 on day 7, has become prevalent to describe graft dysfunction including SFSS after LDLT. Although various efforts have been made to overcome EAD in LDLT, graft selection to maintain an expected GRWR >0.8 and full venous drainage, as well as inflow modulation using splenic artery ligation, have become standard in recent LDLT.
摘要：
成人活体肝移植（LDLT）的早期系列显示，移植物体积标准肝脏体积比的安全下限为25％-45％。随后的全球大型LDLT系列提出了0.8的移植物受体重量比（GRWR），以定义成人LDLT中的小型移植物（SFSG）。此后,研究人员确定了先天的和不可避免的因素,包括成像研究期间肝脏体积的变化和灌注溶液引起的移植物收缩.尽管2000年代提倡的小型综合征（SFSS）的定义主要基于长期的胆汁淤积和腹水输出，SFSS一词不足以描述可能由多种因素引起的临床表现.因此，术语“早期同种异体移植功能障碍(EAD)，以总胆红素>10mg/dL或第7天国际标准化比率>1.6为特征的凝血病已普遍用于描述LDLT后的移植物功能障碍，包括SFSS。尽管已经做出了各种努力来克服LDLT中的EAD，移植物选择以保持预期的GRWR>0.8和全静脉引流，以及使用脾动脉结扎的流入调节，在最近的LDLT中已成为标准。
