Elsevier

Transplantation Proceedings

Volume 47, Issue 10, December 2015, Pages 2939-2943
Transplantation Proceedings

Transplantation in the Twenty-First Century
Liver transplantation
Three Case Reports of Splenic Artery Steal Syndrome After Liver Transplantation

https://doi.org/10.1016/j.transproceed.2015.10.037Get rights and content

Highlights

  • The study of splenic artery steal after liver transplantation is not common, though the treatment and diagnosis methods are more mature.

  • This study analyzed the development process of splenic artery steal.

Abstract

Splenic artery steal syndrome (SASS) has gained attention as a complication involving the hepatic artery and can cause ischemia in a grafted liver. This article presents 3 patients with SASS, including their diagnosis and treatment. Contrast-enhanced ultrasonography and angiography are useful in diagnosing SASS, and splenic artery trunk embolization is an effective treatment. The purpose of this article is to reinforce the understanding of the development and progression of SASS.

Section snippets

Patient 1

A 54-year-old man with hepatitis B cirrhosis that progressed to end-stage liver failure had a successful orthotopic liver transplantation. The laboratory values obtained on postoperative day (POD) 1 were as follows: alanine aminotransferase (ALT), 49.8 U/L (reference range, 7–40 U/L); aspartate aminotransferase (AST), 78.7 U/L (13.0–35 U/L); and and total bilirubin (T-Bil), 34.7 μmol/L (0–17.1 μmol/L). On POD 2, the following values were obtained: ALT, 194.5 U/L; AST, 213.2 U/L; and T-Bil,

Discussion

Liver transplantation has become a routine procedure in all types of end-stage liver diseases, and the complications are increasingly appreciated. Some of the most common potential complications are vascular and biliary, allograft rejection, and post-transplantation neoplasms. SASS is one of the vascular complications after liver transplantation and is caused by liver ischemia in addition to hepatic artery thrombosis and stenosis. The incidence been reported is ∼3.1%–5.9% of liver

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