Resection and partial liver transplantation from deceased donors with delayed total hepatectomy (RAPID procedure) for hepatocellular carcinoma: a national, multicenter, non-randomized, prospective trial

Table 1 Algorithm for management of elevated Portal Vein Pressure (PVP) in liver transplantation

PVP—Portal Vein Pressure	Portal Modulation intervention
PVP ≤ 15 mmHg	No modulation required
PVP > 15 mmHg	Portal flow modulation is required until PVP is ≤ 15 mmHg
	1. Somatostatin injection IV bolus 250 μg followed by intravenous 250 μg/hour
	2. Splenic artery ligation
	3. Partial portal vein ligation (banding)
	4. Calibrated portocaval shunt
	5. Splenectomy

Flowchart illustrating the sequential interventions recommended to achieve and maintain portal vein pressure (PVP) ≤ 15 mmHg after graft reperfusion. Initial management begins with intravenous administration of somatostatin (bolus 250 µg followed by continuous infusion at 250 µg/hour). If target PVP remains unmet, subsequent steps include splenic artery ligation, partial portal vein ligation (banding), calibrated portocaval shunt, and ultimately splenectomy, progressing sequentially as needed until PVP ≤ 15 mmHg is achieved

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