Small-for-size syndrome. Report of one case

• Published in: Revista medíca de Chile Vol. 137; no. 7; pp. 918 - 922
• Main Authors: Yarur, Andrés, Castro, Lorena, Segovia, Roberto, Roblero, Juan Pablo, Uribe, Mario, Ferrario, Mario, Buckel, Erwin
• Format: Journal Article
• Language: Spanish
• Published: Chile 01.07.2009
• Subjects: Anastomosis, Surgical - methods; Hepatic Veins - physiopathology; Hepatic Veins - surgery; Humans; Hyperbilirubinemia - etiology; Hyperbilirubinemia - surgery; Liver Transplantation - adverse effects; Liver Transplantation - methods; Male; Middle Aged; Regional Blood Flow - physiology; Syndrome
• ISSN: 0034-9887

Although the use of cadaveric split or living donor liver transplantation is a valid option for liver transplants, they have several complications, being the "small-for-size syndrome" one of the most frequent. This entity is mainly due to the incapacity that the graft has to meet the blood drainage demands. We report a 61 year-old patient with sub-acute liver failure, transplanted with a partial liver graft that developed hyperbilirubinemia, ascites and liver function deterioration. A meso-caval shunt was performed, after which the ascites resolved, serum bilirubin normalized and the synthetic function of the liver improved. After one month, a follow-up CT seen showed the absence of blood flow in the shunt, possible due to the reduction of the hyper-perfusion of the liver. The clinical and biochemical condition of the patient continued improving despite the lack of flow through the shunt.