Splenic Artery Embolization for Splenic Artery Steal Syndrome After Living Donor Liver Transplantation: A Case Report |
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| Affiliation: | 1. Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China;2. Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China;1. Core Internal Medicine, University of Alberta, Edmonton, Alberta, Canada;2. Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada;3. Department of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Menoufia, Egypt;4. Division of Nephrology, University of British Columbia and Immunology Laboratory, Vancouver General Hospital, Vancouver, British Columbia, Canada;5. Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada;6. Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada;1. Division of Clinical Pharmacy, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil;2. Heart Transplant Program, Division of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil;3. Interventional Cardiology Unit, Division of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil;1. Department of Urology, Juntendo University Graduate School of Medicine, Tokyo, Japan;2. Department of Nephrology, Juntendo University Graduate School of Medicine, Tokyo, Japan;1. Surgery Department, Section of Transplantation, Armed Forces Hospitals Southern Region, Khamis Mushayt, Saudi Arabia;2. Radiology Department, Armed Forces Hospitals Southern Region, Khamis Mushayt, Saudi Arabia;3. Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Kasr Al-Ainy St., Egypt;4. Urology Department, Armed Forces Hospitals Southern Region, Khamis Mushayt, Saudi Arabia;5. Vascular Surgery Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar;6. Nephrology Department, Armed Forces Hospitals Southern Region, Khamis Mushayt, Saudi Arabia;7. Anesthesia Department, Armed Forces Hospitals Southern Region, Khamis Mushayt, KSA;8. Anesthesia Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt;9. Pharmacy Department, Armed Forces Hospitals Southern Region, Khamis Mushayt, Saudi Arabia;10. Radiology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt |
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| Abstract: | ![]()
Splenic artery steal syndrome (SASS) has been considered a life-threatening complication to liver transplant recipients. Herein we timely diagnosed a case of SASS with deteriorating liver function. SASS was screened by routine Doppler ultrasonography (DUS) and multidetector computed tomography and was ultimately diagnosed by selective celiac trunk angiography. The patient was rescued by splenic artery embolization. In this case, routine DUS was useful to screen SASS. Signs of high-resistance hepatic artery waveform and low diastolic flow were highly suspected of SASS. This case also indicated that portal hyperperfusion was a cause of graft dysfunction in SASS. The study was in accordance with the Helsinki Congress and the Declaration of Istanbul, no prisoners were used, and participants were neither paid nor coerced in this study. Furthermore, we reviewed the recent literatures on the advances in the diagnosis and treatment of SASS. These studies suggest that splenic artery embolization may be a safe and effective technique to treat SASS. In addition, identification of recipients at high risk of SASS with preoperative computed tomography scans and DUS is recommended. Banding or ligation the splenic artery may be useful to prevent SASS and other potential complications after liver transplantation. |
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