Early diagnosis and treatment of splenio artery steal syndrome after liver transplantation

A. Kirshin, A. Y. Teregulov, A. R. Kirshina
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Abstract

Objective: to study the incidence of splenic artery steal syndrome (SASS) in our own series of liver transplant surgeries and to determine diagnostic and therapeutic tactics.Materials and Methods. During the 3.5 years of existence of the liver transplant program in the Republic of Tatarstan, 77 cadaveric liver transplantations (LTx) have been performed. Postoperative SASS occurred in 4 cases (5.2%). Among the patients were 3 women and 1 man; mean age was 38 years. Doppler ultrasonography of the liver vessels and celiacography were used for diagnosis. Proximal splenic embolization was used as a way to correct the syndrome.Results. In all clinical cases, SASS was timely diagnosed and corrected by endovascular image-guided intervention. The patients were discharged with good hepatic graft function. The complication did not affect the length of hospital stay.Conclusion. SASS remains a severe vascular complication of LTx, which can lead to graft dysfunction and possible loss. Timely detection and treatment prevent severe consequences for the liver recipient.
肝移植术后脾动脉偷血综合征的早期诊断与治疗
目的:探讨脾动脉偷取综合征(SASS)在我院系列肝移植手术中的发病率,探讨其诊断和治疗策略。材料与方法。在鞑靼斯坦共和国开展肝移植项目的3年半时间里,实施了77例尸体肝移植手术。术后发生SASS 4例(5.2%)。其中女性3例,男性1例;平均年龄38岁。应用肝血管多普勒超声及腹腔造影进行诊断。采用脾近端栓塞术纠正综合征。所有临床病例均通过血管内影像引导介入及时诊断和纠正SASS。患者出院时肝移植功能良好。并发症对住院时间无影响。SASS仍然是LTx的严重血管并发症,可导致移植物功能障碍和可能的损失。及时发现和治疗可防止对肝脏受者造成严重后果。
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