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Case Reports
. 2025 Apr 18;17(4):e82553.
doi: 10.7759/cureus.82553. eCollection 2025 Apr.

Portal Flow Modulation During Liver Transplantation for Acute Liver Failure: A Case Report

Pilar Leal-Leyte  1 , Armando Baeza-Zapata  2 , Frida M Mendoza-Jaimes  3 , Jose A Avila-Armendariz  4 , Arturo Luevano-Gonzalez  5 , Daniel Zamora-Valdés  6
Affiliations
Case Reports

Portal Flow Modulation During Liver Transplantation for Acute Liver Failure: A Case Report

Pilar Leal-Leyte et al. Cureus. .

Abstract

Small-for-size syndrome during living donor liver transplantation has been widely studied. Whole allograft deceased donor liver transplantation from small pediatric donors is challenging and may face the same risks and complications. Here, we report a case of an adult patient with acute liver failure who underwent liver transplantation using a pediatric donor graft, combined with splenectomy as portal inflow modulation.

Keywords: acute liver failure; case report; inflow modulation; liver transplantation; portal pressure.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Liver allograft prior to the backtable procedure (weight: 470 g).
Figure 2
Figure 2. Explanted liver.
(A) Operative specimen immediately after resection. (B) Coronal slice of formaldehyde-fixed tissue. (C) Microphotograph (40×) of hematoxylin and eosin-stained slide showing extensive hepatocyte necrosis.
Figure 3
Figure 3. Unenhanced abdominal computed tomography on postoperative day 6 showing (A) no intra-abdominal complications, the presence of an incisional hematoma, and (B) a liver graft volume of 924.8 cc.
Figure 4
Figure 4. Postoperative abdominal computed tomography with intravenous contrast one year after transplantation.
(A) Digital reconstruction of the arterial phase showing a variant right hepatic artery and a patent anastomosis of the graft’s proper hepatic artery. (B) Coronal reconstruction of the portal phase showing a normal liver graft with a patent portal vein.
See this image and copyright information in PMC

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