Correlation Between Splenectomy and Portal Vein Complications in Living Donor Liver Transplantation

Miyagi, Shigehito; Nakanishi, Chikashi; Hara, Yasuyuki; Nakanishi, Waka; Tokodai, Kazuaki; Shimizu, Kenji; Uematsu, Satomi; Kumata, Hiroyuki; Kakizaki, Yuta; Goto, Makoto; Kamei, Takashi; Unno, Michiaki; Satoh, Susumu

doi:10.1016/j.transproceed.2018.03.104

Cited by 3 publications

(3 citation statements)

References 6 publications

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“…Of these, the splenectomy has demonstrated a high gradient fall in portal flow and was commonly performed prior to the advent of directly acting antivirals (DAAs) for Hepatitis C. Splenectomy had other benefits of improving the platelet counts, and response to interferon therapy. Furthermore, it promoted liver regeneration by increased serotonin from platelets and negating the liver inhibitory cytokines released from the spleen 9,23,29,31 . Nonetheless, of the nine articles in our review which included splenectomy as a mode of PIM, five noted higher morbidity (hemorrhage, portal vein and splenic vein thrombosis, infectious complications and/or pancreatic leak) due the procedure (Table 2).…”

Section: Discussionmentioning

confidence: 93%

“…platelets and negating the liver inhibitory cytokines released from the spleen. 9,23,29,31 Nonetheless, of the nine articles in our review which included splenectomy as a mode of PIM, five noted higher morbidity (hemorrhage, portal vein and splenic vein thrombosis, infectious complications and/or pancreatic leak) due the procedure (Table 2). Consequently, it has lost favor as the chosen method of PIM, unless other methods of PIM are unsuccessful.…”

Section: Summary Of Findingsmentioning

confidence: 99%

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Does modification of portal pressure and flow enhance recovery of the recipient after living donor liver transplantation? A systematic review of literature and expert panel recommendations

Rammohan

Rela

Kim

et al. 2022

Clinical Transplantation

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Background: Portal inflow modulation (PIM) aimed at reducing portal hyperperfusion is commonly used in living donor liver transplantation (LDLT) to reduce the risk of small-for-size syndrome (SFSS). Many different techniques, both pharmacological and surgical have been used for this purpose. There is, however, little consensus on the best method of PIM, its exact role in preventing SFSS and on early post-LDLT recovery.Objectives: To identify whether modifications of portal pressures and flows enhance recovery after LDLT and to provide international expert panel recommendations.Data sources: Ovid MEDLINE, Embase, Scopus, Google Scholar, and Cochrane Central.Methods: Systematic review following PRISMA guidelines and recommendations using the GRADE approach derived from an international expert panel. PROSPERO ID: CRD42021260997.Results: Five hundred and ninety four articles were identified through databases' search. Of the 24 included for a final review by the working group (WG), there were five randomized control trials, four prospective studies and 15 retrospective series. Six

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Section: Discussionmentioning

confidence: 93%

Section: Summary Of Findingsmentioning

confidence: 99%

Does modification of portal pressure and flow enhance recovery of the recipient after living donor liver transplantation? A systematic review of literature and expert panel recommendations

Rammohan

Rela

Kim

et al. 2022

Clinical Transplantation

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“…Additionally, animals were not fasted prior to data collection, despite evidence that feeding is able to effect rate of blood flow into the liver ( Reininger and Spirstein, 1957 ). Yet, high portal pressure in human liver resection and transplant patients correlates with poor outcomes ( Aguiar et al, 2011 ; Yang et al, 2016 ; Miyagi et al, 2018 ). Conversely, surgically implanted shunts that limit increase in portal pressure can severely impair the regrowth response ( Marubashi et al, 2004 ).…”

Section: Discussionmentioning

confidence: 99%

Longitudinal ultrasound imaging and network modeling in rats reveal sex-dependent suppression of liver regeneration after resection in alcoholic liver disease

Barnhart

Kan²,

Srivastava³

et al. 2023

Front. Physiol.

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Liver resection is an important surgical technique in the treatment of cancers and transplantation. We used ultrasound imaging to study the dynamics of liver regeneration following two-thirds partial hepatectomy (PHx) in male and female rats fed via Lieber-deCarli liquid diet protocol of ethanol or isocaloric control or chow for 5–7 weeks. Ethanol-fed male rats did not recover liver volume to the pre-surgery levels over the course of 2 weeks after surgery. By contrast, ethanol-fed female rats as well as controls of both sexes showed normal volume recovery. Contrary to expectations, transient increases in both portal and hepatic artery blood flow rates were seen in most animals, with ethanol-fed males showing higher peak portal flow than any other experimental group. A computational model of liver regeneration was used to evaluate the contribution of physiological stimuli and estimate the animal-specific parameter intervals. The results implicate lower metabolic load, over a wide range of cell death sensitivity, in matching the model simulations to experimental data of ethanol-fed male rats. However, in the ethanol-fed female rats and controls of both sexes, metabolic load was higher and in combination with cell death sensitivity matched the observed volume recovery dynamics. We conclude that adaptation to chronic ethanol intake has a sex-dependent impact on liver volume recovery following liver resection, likely mediated by differences in the physiological stimuli or cell death responses that govern the regeneration process. Immunohistochemical analysis of pre- and post-resection liver tissue validated the results of computational modeling by associating lack of sensitivity to cell death with lower rates of cell death in ethanol-fed male rats. Our results illustrate the potential for non-invasive ultrasound imaging to assess liver volume recovery towards supporting development of clinically relevant computational models of liver regeneration.

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Risks of Living Donor Liver Transplantation Using Small-For-Size Grafts

Miyagi

Shono

Tokodai

et al. 2020

Transplantation Proceedings

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Correlation Between Splenectomy and Portal Vein Complications in Living Donor Liver Transplantation

Cited by 3 publications

References 6 publications

Does modification of portal pressure and flow enhance recovery of the recipient after living donor liver transplantation? A systematic review of literature and expert panel recommendations

Does modification of portal pressure and flow enhance recovery of the recipient after living donor liver transplantation? A systematic review of literature and expert panel recommendations

Longitudinal ultrasound imaging and network modeling in rats reveal sex-dependent suppression of liver regeneration after resection in alcoholic liver disease

Risks of Living Donor Liver Transplantation Using Small-For-Size Grafts

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