Effect of Pediatric Living-donor Liver Transplantation on Splenomegaly

Background: The effect of pediatric partial liver transplantation on hypersplenism has not yet been clarified.

Methods: Fifty-five consecutive pediatric patients who underwent living-donor liver transplantation were analyzed. The volume of the spleen was measured by computed tomography, and the spleen volume-to-standard spleen volume ratio (R) was calculated in each patient. The platelet counts were examined preoperatively and at 1, 6, 12, 18, 24, 36, and 48 months after the operation. The rate of the decline in this ratio during 1 year was calculated, and correlations with clinical factors were examined.

Results: The ratio decreased gradually after the operation in all of the patients except for three with an eventful postoperative course. The rate of the reduction in R within 1 year after the operation was well correlated with preoperative R (R(O); P<0.0001), which led to an equation for R at n months after the operation: R(n) =(0.31-0.21R(O) )Ln(3.3n+1)+R(O). The platelet counts increased rapidly in the patients with the uneventful postoperative course.

Conclusions: The normalization of spleen size can be expected with an uneventful living-donor liver transplantation. The spleen volume decreased more rapidly in patients with a larger spleen.