Delayed splenic artery occlusion for treatment of established small-for-size syndrome after partial liver transplantation

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書誌事項

公開日
2009-02
権利情報
  • http://doi.wiley.com/10.1002/tdm_license_1.1
DOI
  • 10.1002/lt.21636
公開者
Ovid Technologies (Wolters Kluwer Health)

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説明

<jats:sec> <jats:title/> <jats:p>We looked at the impact of delayed splenic artery occlusion (SAO) on recipients with established small-for-size syndrome (SFSS) after partial graft liver transplantation [either from a living donor (LD) or split from a deceased donor (DD)]. Between 1999 and 2007 we performed a total of 100 partial liver transplantations in adult recipients: 66 LD transplantations and 34 DD split transplantations. Of these, 7 (7%) developed SFSS, diagnosed by the clinical features of cholestasis, coagulopathy, and ascites. Mean graft weight/recipient weight (GW/RW) ratio in these 7 recipients was 0.94%. Five of these 7 recipients underwent relaparotomy at a mean of 10 days post-transplantation to rule out a technical complication, and then intraoperative splenic artery ligation was performed. The other 2 recipients were treated radiologically by splenic artery coiling—at 9 and 13 days post-transplantation. Median serum bilirubin at the time of the splenic artery procedure was 20 mg/dL; by 3 weeks postprocedure this had decreased to 2.5 mg/dL. Of the 7 recipients with SFSS, 6 improved and eventually obtained normal graft function; 1 recipient did not improve and ultimately underwent retransplantation because of persistent cholestasis and failure to thrive. Delayed SAO represents a potential option for the treatment of recipients with established SFSS after partial liver transplantation.</jats:p> </jats:sec>

収録刊行物

  • Liver Transplantation

    Liver Transplantation 15 (2), 163-168, 2009-02

    Ovid Technologies (Wolters Kluwer Health)

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