Due to the growing shortage of donor livers, more patients are waiting for liver transplantation. Efforts to expand the donor pool include the use of living donor liver transplantation (LDLT) and split liver transplantation. LDLT involves a healthy person undergoing a partial hepatectomy to donate a part of his liver to a patient with severe liver failure. Afterwards, the regenerative capacity of the organ allows the livers of both donor and recipient to regrow to normal liver masses. The procedure is not without risk as serious complications may occur (such as cholestasis, ascites, gastrointestinal bleeding and renal impairment). An inadequate liver mass compared to the body mass may result in the small-for-size syndrome (SFSS). In both donor and recipient, LDLT may lead to portal hypertension associated with the elevated intrahepatic resistance of a smaller liver, and an increased portal venous (PV) inflow per gram of liver tissue compared to the total liver before resection. Excessive hyperperfusion and shear stress may damage the sinusoidal endothelial cells and lead to graft dysfunction.

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