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Splenohepatic arterial steal syndrome in liver transplantation: clinical features and management

2002; Springer Science+Business Media; Volume: 15; Issue: 2-3 Linguagem: Inglês

10.1007/s00147-002-0386-0

1432-2277

Ina Geissler, P. Lamesch, Helmut Witzigmann, U. Jost, Johann Hauss, J. Fangmann,

Transplantation: Methods and Outcomes

Well-known arterial complications after liver transplantation comprise thrombosis and major stenosis, which usually necessitate a retransplantation procedure. In our institution, in a series of 165 consecutive liver transplantations, we report the first recognized case of a splenohepatic arterial steal syndrome. This is characterized by an arterial malperfusion of the hepatic graft caused by a marked diversion of blood flow to a significantly enlarged spleen, which leads to major ischemic damage of the hepatic graft. After splenectomy the perfusion through the hepatic artery increased substantially and the graft was salvaged, with a following favorable clinical course. Splenohepatic arterial steal syndrome may ultimately result in graft loss if it is falsely diagnosed or recognized too late. A post-transplantation splenectomy represents a successful therapeutic approach; alternatively a primary arterial anastomosis to the aorta prevents the development of this condition.