TY - JOUR
T1 - Partial splenic artery embolization for thrombocytopenia and uncontrolled massive ascites after liver transplantation
AU - Kim, H.
AU - Suh, K. S.
AU - Jeon, Y. M.
AU - Park, M. S.
AU - Choi, Y.
AU - Mori, S.
AU - Hong, G.
AU - Lee, H. W.
AU - Yi, N. J.
AU - Lee, K. W.
PY - 2012/4
Y1 - 2012/4
N2 - Thrombocytopenia (platelet < 60,000/mm 3) and uncontrolled massive ascites (ascitic fluid > 1000 mL/d over 10 days) after liver transplantation (OLT), although uncommon, usually represent serious complications. Splenectomy is a useful treatment despite its many side effects. Recently, partial splenic artery embolization (PSAE) is considered to be a nonsurgical, less invasive treatment. In this study, we retrospectively reviewed the results of PSAE after OLT. Between October 2008 and February 2010, 11 patients underwent PSAE after OLT due to thrombocytopenia (n = 6) or refractory ascites (RA; n = 5). Six patients (54.5%) were males and 3 (27.3%) were children. The primary liver disease was virus-related liver cirrhosis (n = 6), biliary atresia (n = 3), fulminant hepatitis (n = 1), or alcoholic liver cirrhosis (n = 1). Seven grafts were from living and four from deceased donors. The major axial size of spleen was 12.1 to 23.4 cm and its average embolized volume, 76.4% (range = 70%-80%). As the result, the platelet count significantly increased after PSAE in all patients maintaining values greater than 100,000/mm 3 in four thrombocytopenic patients (66.7%). Cases of RA showed marked decreases after PSAE (100%). The follow-up was 6 to 28 months. After PSAE, patients experienced abdominal pain (n = 9, 81.8%), fever (n = 2, 18.2%), and abdominal distension (n = 2, 18.2%). However, there was no serious complication after PSAE such as splenic abscess, rupture, pancreatic infarction, sepsis, or death. In conclusion, PSAE was effective and safe and can be the choice for thrombocytopenia or RA related to hypersplenism after OLT.
AB - Thrombocytopenia (platelet < 60,000/mm 3) and uncontrolled massive ascites (ascitic fluid > 1000 mL/d over 10 days) after liver transplantation (OLT), although uncommon, usually represent serious complications. Splenectomy is a useful treatment despite its many side effects. Recently, partial splenic artery embolization (PSAE) is considered to be a nonsurgical, less invasive treatment. In this study, we retrospectively reviewed the results of PSAE after OLT. Between October 2008 and February 2010, 11 patients underwent PSAE after OLT due to thrombocytopenia (n = 6) or refractory ascites (RA; n = 5). Six patients (54.5%) were males and 3 (27.3%) were children. The primary liver disease was virus-related liver cirrhosis (n = 6), biliary atresia (n = 3), fulminant hepatitis (n = 1), or alcoholic liver cirrhosis (n = 1). Seven grafts were from living and four from deceased donors. The major axial size of spleen was 12.1 to 23.4 cm and its average embolized volume, 76.4% (range = 70%-80%). As the result, the platelet count significantly increased after PSAE in all patients maintaining values greater than 100,000/mm 3 in four thrombocytopenic patients (66.7%). Cases of RA showed marked decreases after PSAE (100%). The follow-up was 6 to 28 months. After PSAE, patients experienced abdominal pain (n = 9, 81.8%), fever (n = 2, 18.2%), and abdominal distension (n = 2, 18.2%). However, there was no serious complication after PSAE such as splenic abscess, rupture, pancreatic infarction, sepsis, or death. In conclusion, PSAE was effective and safe and can be the choice for thrombocytopenia or RA related to hypersplenism after OLT.
UR - http://www.scopus.com/inward/record.url?scp=84859496062&partnerID=8YFLogxK
U2 - 10.1016/j.transproceed.2012.01.066
DO - 10.1016/j.transproceed.2012.01.066
M3 - Article
C2 - 22483487
AN - SCOPUS:84859496062
VL - 44
SP - 755
EP - 756
JO - Transplantation Proceedings
JF - Transplantation Proceedings
SN - 0041-1345
IS - 3
ER -
