2014
DOI: 10.1016/j.ijsu.2014.09.012
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Splenic artery syndrome after orthotopic liver transplantation: A review

Abstract: Splenic Artery Syndrome (SAS) has emerged as a controversial cause for graft ischemia in orthotopic liver transplant (OLTx) recipients. A complex combination of factors including hepatic artery hypoperfusion and portal hyperperfusion can result in SAS. Clinical and laboratory findings suggest graft ischemia but are generally non-specific. Conventional angiography findings of hepatic artery hypoperfusion with early and rapid filling of the splenic artery are suggestive of the diagnosis in the appropriate clinic… Show more

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Cited by 30 publications
(23 citation statements)
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References 38 publications
(83 reference statements)
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“…Six patients had an abnormal arterial flow at their USD check during the first month. A splenic artery steal syndrome was diagnosed in five patients, typically during the first week (days 1‐4), and typically also in five children who had severe and long‐standing portal hypertension (cirrhotic condition with mean age at transplant = 10 years): Four patients were treated radiologically (proximal splenic artery embolization) and one was treated by a surgical reexploration with a graft repositioning and a ligation of the splenic artery . Another patient was diagnosed during the third week with an arterial stricture, and this was treated successfully by a percutaneous angioplasty (POD 17).…”
Section: Resultsmentioning
confidence: 99%
“…Six patients had an abnormal arterial flow at their USD check during the first month. A splenic artery steal syndrome was diagnosed in five patients, typically during the first week (days 1‐4), and typically also in five children who had severe and long‐standing portal hypertension (cirrhotic condition with mean age at transplant = 10 years): Four patients were treated radiologically (proximal splenic artery embolization) and one was treated by a surgical reexploration with a graft repositioning and a ligation of the splenic artery . Another patient was diagnosed during the third week with an arterial stricture, and this was treated successfully by a percutaneous angioplasty (POD 17).…”
Section: Resultsmentioning
confidence: 99%
“…Although coil embolization for splenic steal syndrome has been previously described [ 5 ], this case represents the first report of its use to salvage a split liver transplant allograft with favorable outcomes. There is no resulting functional asplenia as the splenic artery is not completely occluded and there is collateral flow through the short gastric arteries.…”
Section: Discussionmentioning
confidence: 99%
“…In addition to the above, CEUS limited the misdiagnosis of hepatic artery thrombosis. 22 During the study performed by Zhu et al, two patients with no detected hepatic artery flow on CFDI were falsely diagnosed with hepatic artery thrombosis, but were shown on CEUS to have low hepatic artery signal consistent with SASS which was confirmed by angiography. Overall, CEUS represents an effective low risk imaging modality for the detection of SASS after OLT.…”
Section: Diagnostic Modalitiesmentioning
confidence: 93%
“…41 For further reading, Pinto et al provide a detailed discussion about the above techniques. 22 Conclusion SAE has exhibited tremendous evolution for the treatment of SASS, a type of NOHAH. SAE improves hepatic arterial flow by disrupting splenic-to-portal circulation, and is beneficial both as a prophylactic and therapeutic minimally invasive endovascular approach.…”
Section: Other Therapiesmentioning
confidence: 99%