Cited by 180Organ Transplantation Techniques and OutcomesLiver physiology and pathologyHepatocellular Carcinoma Treatment and Prognosis

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The ???small for size??? liver syndrome

Tucker, O N, Heaton, N·2005·Current Opinion in Critical Care

DOI 10.1097/01.ccx.0000157080.11117.45

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Abstract

Purpose of review Small-for-size syndrome (SFSS) is a clinical syndrome described following liver transplantation (LT) and extended hepatectomy. New evidence has emerged documenting the importance of preoperative evaluation of functional liver mass, liver quality, influence of portal hypertension, and variations in surgical technique to improve outcome. Recent findings SFSS is characterized by postoperative coagulopathy and liver dysfunction due to insufficient functional liver mass. Recent radiologic advances allow accurate preoperative estimation of total, graft, and remnant liver volume (RLV). In adult-to-adult living donor liver transplantation (LDLT), a graft-to-recipient body weight ratio > or = 0.8% or graft weight ratio > or = 30% are important to avoid SFSS. Minimal functional RLV following extended hepatectomy is > or = 25% in a normal liver, and > or = 40% with preoperative liver dysfunction. Preoperative portal vein or hepatic artery embolization to increase RLV and function after extended hepatectomy, and the increasing use of parenchymal-sparing segmental resections have improved outcome. In LT, the evolving use of split livers, LDLT and marginal grafts has resulted in increased recognition of SFSS. This has led to a renewed interest in defining the pathophysiology, and the development of new surgical techniques to reduce its incidence. Summary Current radiologic imaging techniques can be used to evaluate liver volume and the risk of SFSS following LT and extend…

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Sutthatarn, P., Taesombat, W., Kruephate, M., Sirichindakul, P., Nonthasoot, B., Achatsachat, P., Techavichit, P., Phewplung, T., & Vejchapipat, P. (2025) · Pediatric Surgery International · doi:10.1007/s00383-025-06249-7
Characterization and prevention of the “small-for-size” syndrome in a porcine model of hepatic transplant
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Bröring, D. C., & Müller, L. P. (2010) · Springer eBooks · doi:10.1007/978-3-642-04935-4_8

Authors: Tucker, O. N., & Heaton, N.
Affiliations: King's College Hospital (GB)
Corresponding author: Heaton, N
ORCID: Heaton, N
Venue: Current Opinion in Critical Care
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2005-04
Volume: 11
Issue: 2
Pages: 150-155
ISSN: 1070-5295 (ISSN-L)
DOI: 10.1097/01.ccx.0000157080.11117.45
OpenAlex: W1985757414
Cited by: 180
References: 65
Citations by year: 2025: 2 · 2024: 4 · 2023: 6 · 2022: 4 · 2021: 7 · 2020: 9 · 2019: 11 · 2018: 6 · 2017: 14 · 2016: 11 · 2015: 7 · 2014: 14 · 2013: 17 · 2012: 14
FWCI: 1.62
Type: journal article
Language: en
Open access: closed
Locations: Current Opinion in Critical Care (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
Health Sciences › Medicine › Hepatology › Liver physiology and pathology
Health Sciences › Medicine › Hepatology › Hepatocellular Carcinoma Treatment and Prognosis
Keywords: small-for-size syndrome, liver transplantation, extended hepatectomy, living donor liver transplantation, remnant liver volume, graft-to-recipient weight ratio, portal hypertension, preoperative embolization, split liver transplantation, marginal grafts, postoperative coagulopathy, liver regeneration
MeSH terms: Adult, Hepatectomy, Humans, Hypertension, Portal, Liver, Organ Size, Syndrome, Liver Transplantation, Hepatic Insufficiency

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