Oura T, Taniguchi M, Shimamura T, Suzuki T, Yamashita K, Uno M, Goto R, Watanabe M, Kamiyama T, Matsushita M, Furukawa H, Todo S
Department of General Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
Am J Transplant. 2008 Jan;8(1):250-2. doi: 10.1111/j.1600-6143.2007.02045.x. Epub 2007 Dec 18.
In order to obviate a small-for-size graft syndrome (SFSGS), a portacaval (PC) shunt had been considered in a case of adult-to-adult living donor liver transplantation (AA-LDLT). In a recent AA-LDLT case, we adopted the PC shunt to resolve SFSGS; however, graft atrophy was observed in the late period of LDLT, thereby resulting in liver dysfunction. Due to the surgical closure of the PC shunt at 11 months post-LDLT, the graft regenerated gradually and resulted in the recovery of the liver function. This experience indicates that the portacaval shunt would overcome SFSGS in the early period of LDLT, while it would cause the graft atrophy and the graft dysfunction in the late period of LDLT.
为避免小体积移植物综合征（SFSGS），在一例成人对成人活体肝移植（AA-LDLT）中考虑了门腔静脉（PC）分流术。在最近的一例AA-LDLT病例中，我们采用PC分流术来解决SFSGS；然而，在肝移植后期观察到移植物萎缩，从而导致肝功能障碍。由于在肝移植术后11个月对PC分流术进行了手术闭合，移植物逐渐再生，肝功能得以恢复。这一经验表明，门腔静脉分流术在肝移植早期可克服SFSGS，但在肝移植后期会导致移植物萎缩和移植物功能障碍。
