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World J Gastroenterol. Sep 7, 2013; 19(33): 5464-5472
Published online Sep 7, 2013. doi: 10.3748/wjg.v19.i33.5464
Published online Sep 7, 2013. doi: 10.3748/wjg.v19.i33.5464
Extracorporeal continuous portal diversion plus temporal plasmapheresis for “small-for-size” syndrome
Peng Hou, Chao Chen, Institute of Gastroenterology, The First Affiliated Hospital of Chinese PLA General Hospital, Beijing 100037, China
Yu-Liang Tu, Zi-Man Zhu, Jing-Wang Tan, Institute of Hepatobiliary Surgery, The First Affiliated Hospital of Chinese PLA General Hospital, Beijing 100037, China
Author contributions: Hou P and Chen C contributed equally to this work; Hou P and Chen C performed the majority of experiments; Tu YL and Zhu ZM provided vital reagents and analytical tools and revised the manuscript; Tan JW designed the study and wrote the manuscript.
Correspondence to: Jing-Wang Tan, Professor, Institute of Hepatobiliary Surgery, The First Affiliated Hospital of Chinese PLA General Hospital, 51 Fucheng Road, Haidian District, Beijing 100037, China. tanjingwang02@yahoo.com.cn
Telephone: +86-10-68486829 Fax: +86-10-68486829
Received: February 24, 2013
Revised: June 14, 2013
Accepted: June 28, 2013
Published online: September 7, 2013
Revised: June 14, 2013
Accepted: June 28, 2013
Published online: September 7, 2013
Core Tip
Core tip: Plasmapheresis (PP) and other artificial liver support (ALS) modalities have been used to treat postoperative liver failure (PLF) and “small-for-size” syndrome (SFSS). However, these modalities did not result in a significant improvement in survival. It is thought that these modalities cannot relieve portal hypertension, thus are inefficacious. This study demonstrated that ECPD plus temporal PP via the portal vein can not only dynamically turn the portal flow to the systematic circulation and attenuate portal overflow injury, but also reduces toxic load. This technique should be undertaken instead of PP or ALS via the systemic circulation in SFSS or PLF, and shows potential for clinical application.