LAUSR

EP05B-025 INFLOW MODULATION IN LIVING DONOR LIVER TRANSPLANT TO REDUCE SMALL FOR SIZE SYNDROME X. S. Ling, Y. X. Koh, S. Y. Lee, B. K. P. Goh, P. C. Cheow, A. Y. F. Chung, C. Y. Chan and P. Raj Singhealth Residency, and Singapore General Hospital, Singapore Introduction: Living Donor Liver Transplantation (LDLT) is the major modality for liver transplantation in Asia. A major consideration is the balance of graft size that can be safely removed from the donor without morbidity versus the graft size sufficiency in the recipient. A smaller graft size relative to the recipient body weight presents a greater relative risk in developing small-for-size (SFS) graft syndrome. We report our local experience with inflow modulation for adult living donor liver transplantation. Method: We reviewed 4 cases of adult LDLT with GWR <0.8 cases with inflow modulation using temporary hemiportocaval shunt (HPCS) and splenectomy in our institutions. Intra-operative portal pressure was measured with a catheter inserted directly into the recipient’s portal vein before and after all anastomosis had been completed and clamps have been removed. The HPCS is taken down upon completion of the portal venous anastomosis. Primary outcome is defined as absence or presence of SFSS in first postoperative week. Result: All 4 patients had a right lobe graft with a GWR of <0.8. Inflow modulation with a temporary PCS and splenectomy was performed in all patients. No patients suffered from SFSS, or developed ascites. Conclusion: Creation of a temporary HPCS and splenectomy is a safe and effective as a method of inflow modulation in LDLT with GWR <0.8, with no patients developing SFSS or ascites.