A Novel Method for the Prevention and Treatment of Small-for-Size Syndrome in Liver Transplantation

Yanhu Feng, Zhijian Han, Baohong Gu, Xuemei Li, Bofang Wang, Facai Guo, Raaj Kumar Praseedom, Furong Wang, Huijuan Cheng, Alexandra Lucas, Yumin Li, Hao Chen

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Currently there is no consensus on the optimal management of small-for-size syndrome following liver transplantation. Here we describe a technique to alleviate portal hypertension and improve the hepatocyte reperfusion in small-for-size liver transplantation in a Lewis rat model. Methods: The rats underwent trans-portal vein intra-hepatic portosystemic shunt using a self-developed porous conical tube (TPIPSS: Fig. 1) on small-for-size liver transplants (SFS) with right lobe graft. The treatment effect was evaluated by comparing hemodynamic parameters, morphological changes, serum parameters, ET-1 and eNOS expression, hepatocyte proliferation and apoptosis, CYP3A2 levels, postoperative complications, and survival between the two groups with SFS liver transplants. Results: Porous conical prosthesis prolonged the filling time of small-for-size grafts. Moreover, grafts with TPIPSS showed a lower portal vein pressure, improved microcirculatory flow, alleviated histological changes, decreased ET-1 and increased eNOS expressions, and significantly less damage to liver function comparing to grafts without TPIPSS. Mean survival and overall 30-day survival were significantly higher in the TPIPSS group. Conclusions: These results demonstrate that porous conical tube as trans-portal vein intra-hepatic portosystemic shunt device is an effective way to alleviate portal vein hypertension and improve hepatocyte reperfusion after small-for-size liver transplantation.

Original languageEnglish (US)
Pages (from-to)2619-2629
Number of pages11
JournalDigestive Diseases and Sciences
Issue number9
StatePublished - Sep 1 2020
Externally publishedYes


  • Liver transplantation
  • Porous conical tube
  • Portal vein hypertension
  • Small-for-size syndrome

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology


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