{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T18:29:22Z","timestamp":1791311362566,"version":"4.3.1"},"reference-count":54,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2010,3,1]],"date-time":"2010-03-01T00:00:00Z","timestamp":1267401600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2010,3,5]],"date-time":"2010-03-05T00:00:00Z","timestamp":1267747200000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"FIS","award":["04\/1238"],"award-info":[{"award-number":["04\/1238"]}]},{"name":"Carlos III Institute of Health"},{"name":"BBVA (Banco Bilbao Vizcaya Argentaria) Foundation"},{"name":"Vanderbilt Medical School Medical Scholars Program"},{"name":"Catalan Foundation of Transplantation"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2010,3]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Understanding the pathogenesis of small-for-size (SFS) syndrome is critical to expanding the applicability of partial liver transplantation. We aimed to characterize its acute presentation and association with alterations in hepatic hemodynamics, microstructure, and regeneration in a porcine model. Eighteen SFS liver transplants were performed. Donors underwent 70% hepatectomy. Partial grafts were implanted into larger recipients. Whole liver transplants were also performed (n = 6). Recipients were followed until death or for 5 days. Hemodynamics were measured, and tissue was sampled intraoperatively and at the study end. Serum was sampled regularly during follow-up. Seventeen SFS transplants and 6 whole liver transplants were included. SFS grafts represented 23.2% (19.3%-25.3%) of the recipients' standard liver volume. The survival rate was 29% and 100% in the SFS and whole liver groups, respectively. The portal venous flow, pressure gradient, and resistance were significantly higher in recipients of SFS grafts versus whole livers after portal and arterial reperfusion. Arterial flow as a percentage of the total liver blood flow was significantly lower after reperfusion in SFS grafts and remained so when measured again after 5 days. Markers of endothelial cell injury increased soon after reperfusion, and those of hepatocellular injury increased later; both predicted the appearance of either graft failure or histological recovery. Proliferative activity peaked earlier and higher among nonsurvivors in the SFS group. Surviving grafts demonstrated a slower but maintained rise in regenerative activity, although metabolic activity failed to improve. In SFS transplantation in the acute setting, portal hyperperfusion is a stimulus for regeneration but may simultaneously cause irreparable endothelial injury. This porcine model not only helps to elucidate the inciting factors in SFS pathogenesis but also offers a clinically relevant means to study its prevention. Liver Transpl 16:364\u2013374, 2010. \u00a9 2010 AASLD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lt.21989","type":"journal-article","created":{"date-parts":[[2010,3,5]],"date-time":"2010-03-05T15:21:03Z","timestamp":1267802463000},"page":"364-374","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":87,"title":["Portal hyperperfusion: Mechanism of injury and stimulus for regeneration in porcine small-for-size transplantation"],"prefix":"10.1097","volume":"16","author":[{"given":"Constantino","family":"Fondevila","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia J.","family":"Hessheimer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Taur\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"S\u00e1nchez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Calatayud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"de Riva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Mu\u00f1oz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Fuster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoni","family":"Rimola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan C.","family":"Garc\u00eda-Valdecasas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-16-20250326","doi-asserted-by":"crossref","first-page":"12311243","DOI":"10.1016\/j.lts.2003.09.018","article-title":"Evolution of liver transplantation in Europe: report of the European Liver Transplant Registry.","volume":"9","author":"Adam","year":"2003","journal-title":"Liver Transpl"},{"key":"R4-16-20250326","first-page":"150155","article-title":"The small for size liver syndrome.","volume":"11","author":"Tucker","year":"2005","journal-title":"Curr Opin Crit Care"},{"key":"R5-16-20250326","doi-asserted-by":"crossref","first-page":"26052610","DOI":"10.1111\/j.1600-6143.2005.01081.x","article-title":"Smallforsize syndrome after partial liver transplantation: definition, mechanisms of disease and clinical implications.","volume":"5","author":"Dahm","year":"2005","journal-title":"Am J Transplant"},{"key":"R6-16-20250326","doi-asserted-by":"crossref","first-page":"544552","DOI":"10.1097\/00000658-199610000-00012","article-title":"Functional analysis of grafts from living donors. Implications for the treatment of older recipients.","volume":"224","author":"Emond","year":"1996","journal-title":"Ann Surg"},{"key":"R7-16-20250326","first-page":"948953","article-title":"Critical graft size in adulttoadult living donor liver transplantation: impact of the recipients disease.","volume":"7","author":"BenHaim","year":"2001","journal-title":"Liver Transpl"},{"key":"R8-16-20250326","doi-asserted-by":"crossref","first-page":"581586","DOI":"10.1053\/jlts.2003.50114","article-title":"Outcome analysis in adulttoadult living donor liver transplantation using the left lobe.","volume":"9","author":"Soejima","year":"2003","journal-title":"Liver Transpl"},{"key":"R9-16-20250326","doi-asserted-by":"crossref","first-page":"S36S41","DOI":"10.1053\/jlts.2003.50200","article-title":"Clinical relevance of adapting portal vein flow in living donor liver transplantation in adult patients.","volume":"9","author":"Troisi","year":"2003","journal-title":"Liver Transpl"},{"key":"R10-16-20250326","doi-asserted-by":"crossref","first-page":"13971404","DOI":"10.1111\/j.1600-6143.2005.00850.x","article-title":"Effects of hemiportocaval shunts for inflow modulation on the outcome of smallforsize grafts in living donor liver transplantation.","volume":"5","author":"Troisi","year":"2005","journal-title":"Am J Transplant"},{"key":"R11-16-20250326","doi-asserted-by":"crossref","first-page":"977980","DOI":"10.1097\/01.TP.0000155245.85967.AD","article-title":"Augmentation of heme oxygenase1 expression in the graft immediately after implantation in adult livingdonor liver transplantation.","volume":"79","author":"Kobayashi","year":"2005","journal-title":"Transplantation"},{"key":"R12-16-20250326","doi-asserted-by":"crossref","first-page":"986993","DOI":"10.1097\/00000478-200608000-00009","article-title":"Pathophysiologic observations and histopathologic recognition of the portal hyperperfusion or smallforsize syndrome.","volume":"30","author":"Demetris","year":"2006","journal-title":"Am J Surg Pathol"},{"key":"R13-16-20250326","doi-asserted-by":"crossref","first-page":"159168","DOI":"10.1097\/01.sla.0000129673.13552.c0","article-title":"FK 409 ameliorates smallforsize liver graft injury by attenuation of portal hypertension and downregulation of Egr1 pathway.","volume":"240","author":"Man","year":"2004","journal-title":"Ann Surg"},{"key":"R14-16-20250326","doi-asserted-by":"crossref","first-page":"621627","DOI":"10.1002\/lt.20630","article-title":"Attenuation of acute phase shear stress by somatostatin improves smallforsize liver graft survival.","volume":"12","author":"Xu","year":"2006","journal-title":"Liver Transpl"},{"key":"R15-16-20250326","doi-asserted-by":"crossref","first-page":"731741","DOI":"10.1007\/s00428-005-0006-3","article-title":"The endothelinnitric oxide balance determines smallforsize liver injury after reducedsize rat liver transplantation.","volume":"447","author":"Palmes","year":"2005","journal-title":"Virchows Arch"},{"key":"R16-16-20250326","doi-asserted-by":"crossref","first-page":"280285","DOI":"10.1001\/archsurg.136.3.280","article-title":"Liver transplantation in rats using smallforsize grafts: a study of hemodynamic and morphological changes.","volume":"136","author":"Man","year":"2001","journal-title":"Arch Surg"},{"key":"R17-16-20250326","doi-asserted-by":"crossref","first-page":"253263","DOI":"10.1002\/lt.20073","article-title":"Porcine partial liver transplantation: a novel model of the smallforsize liver graft.","volume":"10","author":"Kelly","year":"2004","journal-title":"Liver Transpl"},{"key":"R18-16-20250326","doi-asserted-by":"crossref","first-page":"181186","DOI":"10.1016\/j.jss.2003.08.007","article-title":"Subtotal hepatectomy: a porcine model for the study of liver regeneration.","volume":"116","author":"Court","year":"2004","journal-title":"J Surg Res"},{"key":"R19-16-20250326","first-page":"1261","article-title":"Perioperative hyaluronic acid levels in orthotopic liver transplant recipient.","volume":"27","author":"Suehiro","year":"1995","journal-title":"Transplant Proc"},{"key":"R20-16-20250326","doi-asserted-by":"crossref","first-page":"266272","DOI":"10.1002\/hep.1840170217","article-title":"Hyaluronic acid uptake by the isolated, perfused rat liver: an index of hepatic sinusoidal endothelial cell function.","volume":"17","author":"Deaciuc","year":"1993","journal-title":"Hepatology"},{"key":"R21-16-20250326","doi-asserted-by":"crossref","first-page":"223228","DOI":"10.1016\/0014-4827(83)90458-5","article-title":"Endothelial cells are a site of uptake and degradation of hyaluronic acid in the liver.","volume":"144","author":"Eriksson","year":"1983","journal-title":"Exp Cell Res"},{"key":"R22-16-20250326","doi-asserted-by":"crossref","first-page":"505510","DOI":"10.1007\/BF00225415","article-title":"Uptake of circulating hyaluronic acid by the rat liver. Cellular localization in situ.","volume":"242","author":"Fraser","year":"1985","journal-title":"Cell Tissue Res"},{"key":"R23-16-20250326","first-page":"23012302","article-title":"Hyaluronic acid in the assessment of liver graft function.","volume":"22","author":"Pollard","year":"1990","journal-title":"Transplant Proc"},{"key":"R24-16-20250326","doi-asserted-by":"crossref","first-page":"907911","DOI":"10.1016\/0016-5085(80)90449-7","article-title":"Thymidine kinase: an inexpensive index of liver regeneration in a large animal model.","volume":"79","author":"Kahn","year":"1980","journal-title":"Gastroenterology"},{"key":"R25-16-20250326","doi-asserted-by":"crossref","first-page":"955966","DOI":"10.1042\/bj1360955","article-title":"Thymidine kinase and deoxyribonucleic acid metabolism in growing and regenerating livers from rats on controlled feeding schedules.","volume":"136","author":"Hopkins","year":"1973","journal-title":"Biochem J"},{"key":"R26-16-20250326","first-page":"S25S29","article-title":"The biology of PECAM1.","volume":"100","author":"Newman","year":"1997","journal-title":"J Clin Invest"},{"key":"R28-16-20250326","doi-asserted-by":"crossref","first-page":"432438","DOI":"10.1097\/00000542-199209000-00005","article-title":"The effect of dobutamine on hepatic blood flow and oxygen supplyuptake ratio during enflurane nitrous oxide anesthesia in humans undergoing liver resection.","volume":"77","author":"Kainuma","year":"1992","journal-title":"Anesthesiology"},{"key":"R29-16-20250326","doi-asserted-by":"crossref","first-page":"355360","DOI":"10.1002\/hep.1840170302","article-title":"Hemodynamic and humoral changes after liver transplantation in patients with cirrhosis.","volume":"17","author":"Navasa","year":"1993","journal-title":"Hepatology"},{"key":"R30-16-20250326","doi-asserted-by":"crossref","first-page":"175178","DOI":"10.1002\/hep.1840170202","article-title":"Persistence of systemic and splanchnic hyperkinetic circulation in liver transplant patients.","volume":"17","author":"Hadengue","year":"1993","journal-title":"Hepatology"},{"key":"R31-16-20250326","doi-asserted-by":"crossref","first-page":"547551","DOI":"10.1053\/jlts.2003.50128","article-title":"Relationship between portal venous flow and liver regeneration in patients after living donor rightlobe liver transplantation.","volume":"9","author":"Eguchi","year":"2003","journal-title":"Liver Transpl"},{"key":"R32-16-20250326","doi-asserted-by":"crossref","first-page":"97102","DOI":"10.1097\/00007890-200301150-00018","article-title":"Factors influencing liver regeneration following livingdonor liver transplantation of the right hepatic lobe.","volume":"75","author":"Maetani","year":"2003","journal-title":"Transplantation"},{"key":"R33-16-20250326","doi-asserted-by":"crossref","first-page":"13881392","DOI":"10.1097\/00007890-199505270-00005","article-title":"Evidence that portal vein decompression improves survival of canine quarter orthotopic liver transplantation.","volume":"59","author":"Ku","year":"1995","journal-title":"Transplantation"},{"key":"R34-16-20250326","doi-asserted-by":"crossref","first-page":"376382","DOI":"10.1111\/j.1432-2277.2003.tb00317.x","article-title":"Portal vein pressure is the key for successful liver transplantation of an extremely small graft in the pig model.","volume":"16","author":"Asakura","year":"2003","journal-title":"Transpl Int"},{"key":"R35-16-20250326","doi-asserted-by":"crossref","first-page":"27822783","DOI":"10.1016\/S0041-1345(02)03412-7","article-title":"Effect of reduction of portal vein pressure on the outcome of extreme small size liver transplants.","volume":"34","author":"Asakura","year":"2002","journal-title":"Transplant Proc"},{"key":"R36-16-20250326","doi-asserted-by":"crossref","first-page":"17371740","DOI":"10.1097\/01.TP.0000062558.71657.E9","article-title":"Effect of mesocaval shunt on survival of smallforsize liver grafts: experimental study in pigs.","volume":"75","author":"Smyrniotis","year":"2003","journal-title":"Transplantation"},{"key":"R37-16-20250326","doi-asserted-by":"crossref","first-page":"355360","DOI":"10.1111\/j.1432-2277.2002.tb00178.x","article-title":"Hemodynamic interaction between portal vein and hepatic artery flow in smallforsize split liver transplantation.","volume":"15","author":"Smyrniotis","year":"2002","journal-title":"Transpl Int"},{"key":"R38-16-20250326","doi-asserted-by":"crossref","first-page":"16971703","DOI":"10.1097\/00007890-200012270-00006","article-title":"The interrelationship between portal and arterial blood flow after adult to adult living donor liver transplantation.","volume":"70","author":"Marcos","year":"2000","journal-title":"Transplantation"},{"key":"R39-16-20250326","doi-asserted-by":"crossref","first-page":"575580","DOI":"10.1097\/00000658-200104000-00014","article-title":"Small graft for living donor liver transplantation.","volume":"233","author":"Nishizaki","year":"2001","journal-title":"Ann Surg"},{"key":"R40-16-20250326","doi-asserted-by":"crossref","first-page":"241250","DOI":"10.1097\/01.tp.0000228867.98158.d2","article-title":"Liver regeneration is suppressed in smallforsize liver grafts after transplantation: involvement of cJun Nterminal kinase, cyclin D1, and defective energy supply.","volume":"82","author":"Zhong","year":"2006","journal-title":"Transplantation"},{"key":"R41-16-20250326","doi-asserted-by":"crossref","first-page":"789795","DOI":"10.1053\/jlts.2003.50170","article-title":"Arterialized partial orthotopic liver transplantation in the mouse: a new model and evaluation of the critical liver mass.","volume":"9","author":"Tian","year":"2003","journal-title":"Liver Transpl"},{"key":"R42-16-20250326","doi-asserted-by":"crossref","first-page":"176180","DOI":"10.1016\/0022-4804(88)90062-5","article-title":"Partial hepatectomy and liver regeneration in pigsthe response to different resection sizes.","volume":"45","author":"Kahn","year":"1988","journal-title":"J Surg Res"},{"key":"R43-16-20250326","doi-asserted-by":"crossref","first-page":"134137","DOI":"10.1006\/jsre.1997.5120","article-title":"Serial ultrasoundguided percutaneous liver biopsy in a partial hepatectomy porcine model: a new technique in the study of liver regeneration.","volume":"70","author":"Chow","year":"1997","journal-title":"J Surg Res"},{"key":"R44-16-20250326","doi-asserted-by":"crossref","first-page":"8693","DOI":"10.1016\/S0014-4800(03)00008-X","article-title":"Hepatic ischemiareperfusion injurya fresh look.","volume":"74","author":"Fondevila","year":"2003","journal-title":"Exp Mol Pathol"},{"key":"R45-16-20250326","doi-asserted-by":"crossref","first-page":"S45S53","DOI":"10.1002\/hep.20969","article-title":"Liver regeneration.","volume":"43","author":"Fausto","year":"2006","journal-title":"Hepatology"},{"key":"R46-16-20250326","first-page":"311320","article-title":"Regulation of renal cytochrome P450. Effects of twothirds hepatectomy, cholestasis, biliary cirrhosis and postnecrotic cirrhosis on hepatic and renal microsomal enzymes.","volume":"34","author":"Babany","year":"1985","journal-title":"Biochem Pharmacol"},{"key":"R47-16-20250326","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1016\/0041-008X(85)90299-6","article-title":"Selective changes in cytochrome P450 and UDPglucuronosyltransferase subpopulations following partial hepatectomy in rats.","volume":"78","author":"Iversen","year":"1985","journal-title":"Toxicol Appl Pharmacol"},{"key":"R48-16-20250326","doi-asserted-by":"crossref","first-page":"35153521","DOI":"10.1016\/0006-2952(88)90705-8","article-title":"Inhibition of cytochrome P450p (P450IIIA1) gene expression during liver regeneration from twothirds hepatectomy in the rat.","volume":"37","author":"Marie","year":"1988","journal-title":"Biochem Pharmacol"},{"key":"R49-16-20250326","doi-asserted-by":"crossref","first-page":"387391","DOI":"10.1097\/00000441-198812000-00004","article-title":"Differential effects of partial hepatectomy on hepatic and renal heme and cytochrome P450 metabolism.","volume":"296","author":"Solangi","year":"1988","journal-title":"Am J Med Sci"},{"key":"R50-16-20250326","doi-asserted-by":"crossref","first-page":"23202323","DOI":"10.2460\/ajvr.1983.44.12.2320","article-title":"Indocyanine green clearance and ammonia tolerance in partially hepatectomized and hepatic devascularized, anesthetized dogs.","volume":"44","author":"Prasse","year":"1983","journal-title":"Am J Vet Res"},{"key":"R51-16-20250326","doi-asserted-by":"crossref","first-page":"39303931","DOI":"10.1016\/j.transproceed.2005.10.082","article-title":"Steroids and living liver donation increase tacrolimus blood levels in living donor liver transplantation.","volume":"37","author":"Charco","year":"2005","journal-title":"Transplant Proc"},{"key":"R52-16-20250326","doi-asserted-by":"crossref","first-page":"219223","DOI":"10.1053\/jlts.2002.30885","article-title":"Tacrolimus dosing requirements and concentrations in adult living donor liver transplant recipients.","volume":"8","author":"Taber","year":"2002","journal-title":"Liver Transpl"},{"key":"R53-16-20250326","doi-asserted-by":"crossref","first-page":"212218","DOI":"10.1053\/jlts.2002.31346","article-title":"Living donor liver transplant recipients achieve relatively higher immunosuppressant blood levels than cadaveric recipients.","volume":"8","author":"Trotter","year":"2002","journal-title":"Liver Transpl"},{"key":"R54-16-20250326","doi-asserted-by":"crossref","first-page":"558565","DOI":"10.1002\/lt.21094","article-title":"Antiinflammatory properties of IL10 rescue smallforsize liver grafts.","volume":"13","author":"Yang","year":"2007","journal-title":"Liver Transpl"},{"key":"RU55-16-20250326","doi-asserted-by":"crossref","first-page":"486492","DOI":"10.1016\/S0039-6060(05)80363-0","article-title":"Partial hepatic grafting: porcine study on critical volume reduction.","volume":"118","author":"Yanaga","year":"1995","journal-title":"Surgery"},{"key":"RU56-16-20250326","doi-asserted-by":"crossref","first-page":"69546959","DOI":"10.3748\/wjg.v11.i44.6954","article-title":"Excessive portal flow causes graft failure in extremely smallforsize liver transplantation in pigs.","volume":"11","author":"Wang","year":"2005","journal-title":"World J Gastroenterol"},{"key":"RU57-16-20250326","doi-asserted-by":"crossref","first-page":"20142022","DOI":"10.1007\/s00268-005-0294-4","article-title":"Effect of portocaval shunt on residual extreme small liver after extended hepatectomy in porcine.","volume":"30","author":"Wang","year":"2006","journal-title":"World J Surg"}],"container-title":["Liver Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flt.21989","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flt.21989","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01445473-201003000-00016","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T13:19:08Z","timestamp":1743254348000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01445473-201003000-00016"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,3]]},"references-count":54,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2010]]}},"URL":"https:\/\/doi.org\/10.1002\/lt.21989","relation":{},"ISSN":["1527-6465"],"issn-type":[{"value":"1527-6465","type":"print"}],"subject":[],"published":{"date-parts":[[2010,3]]}}}