CHALLNEGE TO OVERCOME LIVING DONOR LIVER TRANSPLANTATION USING SMALL-FOR-SIZE GRAFT

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Small-for-size liver grafts are a serious obstacle for partial orthotopic liver transplantation. The results using a rat model suggest that a preservation solution containing APC is a potential novel and safe product for small-for-size liver transplantation, alleviating graft injury via anti-inflammatory and antiapoptotic effects and vasorelaxing conditions. Additionally, splenectomy before transplantation inhibited leukocyte infiltrations and pro-inflammatory cytokine synthesis which leads to hepatocellular apoptosis and impaired liver regeneration. Clinically, control of portal venous pressure immediately after living donor liver transplantation using small-for-size liver graft is very important, and preoperative assessment of the recipient's spleen volume and graft volume is very helpful to determine the necessity of splenectomy.