Effect of Liver Transplantation on Spleen Size, Collateral Veins, and Platelet Counts

Overview

Journal World J Surg

Publisher Wiley

Specialty General Surgery

Date 2009 Dec 17

PMID 20012612

Citations 18

Authors

Fumio Chikamori

Seigo Nishida

Gennaro Selvaggi

Panagiotis Tryphonopoulos

Jang I Moon

David M Levi

Tomoaki Kato

Eddie R Island

Akira Maki

Akin Tekin

Andreas G Tzakis

Affiliations

Soon will be listed here.

Abstract

Background: The aim of this study was to evaluate the effect of liver transplantation on the spleen size, spontaneous splenorenal shunt (SRS) function, and platelet counts in patients with hypersplenism.

Methods: Between December 2001 and February 2007, 462 adult patients underwent orthotopic liver transplantations (OLTX) at our institution. Of these patients, CT or MRI information was reviewed retrospectively in 55 patients. Volume measurements of the spleen and liver, spleen/liver volume ratio (S/L ratio), presence and size of SRS, and platelet counts were evaluated before and after OLTX.

Results: Mean spleen volume decreased from 827 +/- 463 ml to 662 +/- 376 ml after OLTX (p < 0.01). Five (11%) patients returned to normal-range spleen size after OLTX. SRS was observed in 19 patients before OLTX (35%). The diameter of SRS also significantly decreased from 1.0 +/- 0.5 cm before OLTX to 0.7 +/- 0.5 cm after OLTX (p < 0.05). SRS disappeared in 16% of patients (3/19). S/L ratio significantly decreased from 0.65 +/- 0.33 to 0.38 +/- 0.17 (p < 0.01) after OLTX. Platelet counts significantly increased after OLTX (p < 0.01). Improvement of the platelet count in the group with postoperative S/L ratio >0.35 was not as good as that in the group with S/L ratio <0.35 (p < 0.01).

Conclusions: Spleen size and SRS size became significantly smaller after OLTX. However, patients with postoperative S/L ratio >0.35 tend to have lower platelet counts after OLTX.

Citing Articles

Emergency transileocolic vein obliteration for life-threatening bleeding from gastric varices.

Chikamori F, Mizobuchi K, Hamada R, Ito S, Uemura S, Yamada R Radiol Case Rep. 2023; 18(4):1570-1575.

PMID: 36824993 PMC: 9941876. DOI: 10.1016/j.radcr.2023.01.045.

Percutaneous transhepatic obliteration for life-threatening bleeding after endoscopic variceal ligation in a patient with severe esophagogastric varices.

Chikamori F, Ito S, Sharma N Radiol Case Rep. 2022; 18(2):624-630.

PMID: 36471734 PMC: 9719002. DOI: 10.1016/j.radcr.2022.10.105.

Verification of thrombus formation just after endoscopic injection sclerotherapy with ligation for esophagogastric varices by venous phase of left gastric arteriography.

Chikamori F, Kanazawa S, Sharma N Radiol Case Rep. 2022; 17(11):4069-4074.

PMID: 36065237 PMC: 9440357. DOI: 10.1016/j.radcr.2022.07.098.

Management of Spontaneous Portosystemic Shunts in 231 Patients Who Underwent Living Donor Liver Transplantation: A Retrospective Study from a Single Center in Nagasaki, Japan.

Hamada T, Hidaka M, Soyama A, Hara T, Imamura H, Matsushima H Ann Transplant. 2022; 27:e936371.

PMID: 35996337 PMC: 9422443. DOI: 10.12659/AOT.936371.

Management of spontaneous portosystemic shunts at the time of liver transplantation: treatment or observation? Results of a systematic review.

Cusumano C, Gussago S, Guerra M, Paul C, Faitot F, Bachellier P Hepatol Int. 2022; 16(5):983-992.

PMID: 35941400 DOI: 10.1007/s12072-022-10377-w.

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