Abstract:

Objective To study the techniques in diagnosis and prevention of splenic artery steal syndrome （SASS）after liver transplantation（LT）. Methods A total of 159 patients who underwent LT in our hospital between Nov 2011 and Apr 2017 were studied，including five patients identified as SASS，and four patients receiving splenic artery ligation（SAL）as a way to prevent SASS. Patients with SASS were diagnosed by Doppler ultrasound and confirmed by subsequent digital subtraction angiography（DSA）. Four patients with SASSs were treated with splenic artery embolization（SAE），and 1 patients with SASS was treated with SAL. Platelet count ＜ 50×109 /L，the cealibre ratio of the splenic artery（SA）and common hepatic artery（CHA）＞ 1.5，portal vein velocity ＞ 50 cm/s were employed as the indication for SAL. Four patients at high risk for SASS received SAL to prevent SASS （pre-SAL）. Results None of the 4 patients who received pre-SAL developed SASS，and all of the 4 patients recovered smoothly. Three of five patients diagnosed as SASS after LT received SAE，and one patient with SASS received SAL. Onepatient developed hepatic artery thrombosisand received thrombolysis and SAE. All of the five patients with SASS recovered smoothly. Conclusion SASS is a serious complication after LT. Pre-SAL is an effective way to prevent SASS in patients at high risk. Timely diagnosis in early stage and salvage intervention of SAE or SAL are effective to prevent further progression and devastating consequences.