Blocking off the splenic artery, either through surgical ligation or radiological coiling, helped six out of seven patients suffering from small-for-size syndrome after a partial liver transplant.
This finding is in the February issue of Liver Transplantation, a journal published by John Wiley & Sons. The article is also available online at Wiley Interscience (www.interscience.wiley.com).
Due to the shortage of liver donors, and the long list of patients in need of a transplant, doctors are increasingly using partial grafts. They may take half of the liver from a living donor, or split the liver of a deceased donor into two usable parts. These techniques have increased the number of transplants being performed; however, they have also led to new problems, such as small-for-size syndrome (SFSS), in which the new liver can't handle the metabolic demands of the recipient.
The syndrome causes liver dysfunction soon after the transplant; symptoms include problems with bile flow and coagulation, and ascites, which is the accumulation of fluid in the abdomen. Without treatment, about 50 percent of patients with SFSS will die of sepsis or another complication. Fortunately, there are ways to treat the condition, although the best approach is unclear.
To examine possible treatments for SFSS, researchers, led by Abhinav Humar of the University of Minnesota, conducted a retrospective database analysis of all adult recipients of partial liver transplants at their center between 1997 and 2007. There were 100 such patients, seven of whom developed SFSS. Five of the seven underwent additional abdominal surgery within two weeks of their transplant, to rule out a technical complication of the transplant, and then to have their splenic artery ligated. The other two patients were treated radiologically by splenic artery coiling.