Features of the SFS Graft Syndrome:
(1) The patient receives a small liver transplant, usually from a living donor.
(2) Following the transplant the patient shows:
(2a) poor bile production with prolonged cholestasis
(2b) delayed synthetic function. Delayed synthesis of coagulation factors results in a coagulopathy.
(2c) intractable ascites
(3) Reduction of serum transaminase levels.
(4) Normal inflow and outflow on Doppler ultrasonography.
(5) No other explanation for the findings other than findings.
The diagnosis is usually made in the first week after the transplant but may be apparent at the time of surgery (based on poor bile production).
Complications:
(1) sepsis
(2) hepatic failure
(3) death
The disorder appears to be related to tissue congestion and portal venous hemodynamics with poor hepatocellular function and regeneration.
Some patients can receive a “small” transplant without problems, while some patients can develop the same findings with an “adequate” transplant.
