Transcatheter Splenic Artery Embolization for Treatment of Small-for-Size Syndrome Following Splenic Artery Steal Blood after Living Donor Liver Transplantation (Report of 2 Cases)_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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李传云 , 卢实春 , 王孟龙 , 赖威 , 伏志 , 曾道炳 , 刘源 , 郭庆良 , 林栋栋 , 武聚山 , 李宁

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Keywords：

脾动脉栓塞; 亲体肝移植; 脾动脉窃血; 小肝综合征

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目的探讨脾动脉栓塞治疗亲体肝移植术后脾动脉窃血所致小肝综合征的疗效。
方法我院2007年4月至2009年9月期间共完成亲体肝移植25例，其中有2例发生脾动脉窃血致小肝综合征，均采用介入技术经皮行脾动脉栓塞治疗。
结果行脾动脉栓塞术后，2例患者腹水逐渐减少，转氨酶水平、血小板及白蛋白水平及肝功能较快恢复正常。栓塞术后1个月复查，肝功能仍基本正常。
结论脾动脉栓塞是治疗肝移植术后脾动脉窃血所致小肝综合征的有效措施。

Citation： 李传云,卢实春,王孟龙,赖威,伏志,曾道炳,刘源,郭庆良,林栋栋,武聚山,李宁. Transcatheter Splenic Artery Embolization for Treatment of Small-for-Size Syndrome Following Splenic Artery Steal Blood after Living Donor Liver Transplantation (Report of 2 Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(5): 425-427. doi: Copy

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4.	Kawasaki S, Makuuchi M, Matsunami H, et al. Living related liver transplantation in adults [J]. Ann Surg, 1998; 227(2): 269-274.
5.	Kiuchi T, Kasahara M, Uryuhara K, et al. Impact of graft size mismatching on graft prognosis in liver transplantation from living donors [J]. Transplantation, 1999; 67(2): 321-327.
6.	Ben-Haim M, Emre S, Fishbein TM, et al. Critical graft size in adult-to-adult living donor liver transplantation: impact of the recipient’s disease [J]. Liver Transpl, 2001; 7(11): 948-953.
7.	Shimizu K, Tashiro H, Fudaba Y, et al. Splenic artery steal syndrome in living donor liver transplantation: a case report [J]. Transplant Proc, 2007; 39(10): 3519-3522.
8.	Sanyal R, Shah SN. Role of imaging in the management of splenic artery steal syndrome [J]. J Ultrasound Med, 2009; 28(4): 471-477.
9.	Uflacker R, Selby JB, Chavin K, et al. Transcatheter splenic artery occlusion for treatment of splenic artery steal syndrome after orthotopic liver transplantation [J]. Cardiovasc Intervent Radiol, 2002; 25(4): 300-306.
10.	Bárcena R, Moreno A, Foruny JR, et al. Improved graft function in liver-transplanted patients after partial splenic embolization: reversal of splenic artery steal syndrome? [J]. Clin Transplant, 2006; 20(4): 517-523.
11.	严律南. 成人间活体肝移植的外科技术与创新 [J]. 中国普外基础与临床杂志, 2008; 15(3): 151-154.
12.	Trotter JF, Suhocki PV, Clavien PA. Hypersplenism and splenic artery steal syndrome following hepatic transplantation successfully treated with splenic artery embolization [J]. Hepatology, 1997; 26(4): 438.
13.	Madoff DC, Denys A, Wallace MJ, et al. Splenic arterial interventions: anatomy, indications, technical considerations, and potential complications [J]. Radiographics, 2005; 25 Suppl 1: S191-S211.
14.	Umeda Y, Yagi T, Sadamori H, et al. Preoperative proximal splenic artery embolization: a safe and efficacious portal decompression technique that improves the outcome of live donor liver transplantation [J]. Transpl Int, 2007; 20(11): 947-955.
15.	Lima CX, Mandil A, Ulhoa AC, et al. Splenic artery steal syndrome after liver transplantation: an alternative technique of embolization [J]. Transplant Proc, 2009; 41(5): 1990-1993.

1. Aucejo F, Hashimoto K, Quintini C, et al. Splenic artery steal syndrome: Reality or myth? A case report suggesting the role of portal hyperperfusion [J]. Liver transplantation, 2007; 13(6): S116.
2. 严律南. 活体肝移植的现状与展望 [J]. 中国普外基础与临床杂志, 2007; 14(2): 128-131.
3. Lo CM, Fan ST, Liu CL, et al. Minimum graft size for successful living donor liver transplantation [J]. Transplantation, 1999; 68(8): 1112-1116.
4. Kawasaki S, Makuuchi M, Matsunami H, et al. Living related liver transplantation in adults [J]. Ann Surg, 1998; 227(2): 269-274.
5. Kiuchi T, Kasahara M, Uryuhara K, et al. Impact of graft size mismatching on graft prognosis in liver transplantation from living donors [J]. Transplantation, 1999; 67(2): 321-327.
6. Ben-Haim M, Emre S, Fishbein TM, et al. Critical graft size in adult-to-adult living donor liver transplantation: impact of the recipient’s disease [J]. Liver Transpl, 2001; 7(11): 948-953.
7. Shimizu K, Tashiro H, Fudaba Y, et al. Splenic artery steal syndrome in living donor liver transplantation: a case report [J]. Transplant Proc, 2007; 39(10): 3519-3522.
8. Sanyal R, Shah SN. Role of imaging in the management of splenic artery steal syndrome [J]. J Ultrasound Med, 2009; 28(4): 471-477.
9. Uflacker R, Selby JB, Chavin K, et al. Transcatheter splenic artery occlusion for treatment of splenic artery steal syndrome after orthotopic liver transplantation [J]. Cardiovasc Intervent Radiol, 2002; 25(4): 300-306.
10. Bárcena R, Moreno A, Foruny JR, et al. Improved graft function in liver-transplanted patients after partial splenic embolization: reversal of splenic artery steal syndrome? [J]. Clin Transplant, 2006; 20(4): 517-523.
11. 严律南. 成人间活体肝移植的外科技术与创新 [J]. 中国普外基础与临床杂志, 2008; 15(3): 151-154.
12. Trotter JF, Suhocki PV, Clavien PA. Hypersplenism and splenic artery steal syndrome following hepatic transplantation successfully treated with splenic artery embolization [J]. Hepatology, 1997; 26(4): 438.
13. Madoff DC, Denys A, Wallace MJ, et al. Splenic arterial interventions: anatomy, indications, technical considerations, and potential complications [J]. Radiographics, 2005; 25 Suppl 1: S191-S211.
14. Umeda Y, Yagi T, Sadamori H, et al. Preoperative proximal splenic artery embolization: a safe and efficacious portal decompression technique that improves the outcome of live donor liver transplantation [J]. Transpl Int, 2007; 20(11): 947-955.
15. Lima CX, Mandil A, Ulhoa AC, et al. Splenic artery steal syndrome after liver transplantation: an alternative technique of embolization [J]. Transplant Proc, 2009; 41(5): 1990-1993.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Transcatheter Splenic Artery Embolization for Treatment of Small-for-Size Syndrome Following Splenic Artery Steal Blood after Living Donor Liver Transplantation (Report of 2 Cases)

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