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KMID : 0870420090130040242
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Korean Journal of Hepato-Biliary-Pancreatic Surgery
2009 Volume.13 No. 4 p.242 ~ p.250
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Effect of Splenic Artery Interruption on Complete Blood Count Profiles in Living Donor Liver Transplant Recipients
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Kim Wan-Joon
Kim Kwan-Woo
Choi Nam-Kyu
Park Gil-Chun
Yu Young-Dong
Park Pyung-Jae
Choi Young-Il
Choi Kun-Moo
Lee Sung-Gyu
Moon Deok-Bog
Park Jeong-Ik
Hwang Shin
Kim Ki-Hun
Ahn Chul-Soo
Ha Tae-Yong
Song Gi-Won
Jung Dong-Hwan
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Abstract
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Purpose: Splenectomy during living donor liver transplantation (LDLT) in a hepatitis C virus (HCV)-related cirrhotic recipient was performed by a Tokyo group to enhance the patient’s tolerability to post-operative anti-viral treatment by improving complete blood count (CBC) profiles. At our institution, interruption of the splenic artery (SPA) by ligation or embolization in lieu of splenectomy, has been performed in LDLT to modulate portal blood flow in small-for-size graft LDLT or to prevent rupture of SPA aneurysms in recipients. We aimed to determine if interruption of the SPA can serve as an alternative management to splenectomy in LDLT recipients based on our data.
Methods: Patients were classified into the splenic artery ligation group (SAL; n=26) and splenic artery embolization group (SAE; n=19), respectively. Among the recipients without SPA interruption, age-, gender-, and severity of cirrhosis-matched 25 recipients were selected as a control group. Post-operative CBC profiles and spleen size were reviewed retrospectively and compared between the groups.
Results: After SAL, platelet and neutrophil counts were significantly increased at 3 and 6 months, and at 1 week and 1 month, respectively (p＜0.05). After SAE, platelet and neutrophil counts were significantly increased at 3 and 6 months, and at 1 week and 3 months, respectively. There were no significant complications related to interruption of the SPA.
Conclusion: Interruption of the SPA may have a role in improving neutrophil and platelet counts in LDLT recipients with severe pancytopenia or in whom antiviral treatment for HCV in anticipated.
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KEYWORD
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Splenic artery, Interruption, Ligation, Embolization, Living donor liver transplantation
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