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Blocking Splenic Artery Helps Liver Transplant Patients With Small-for-Size Syndrome HOBOKEN, NJ -- February 4, 2009 -- Blocking off the splenic artery, either through surgical ligation or radiological coiling, helped 6 out of 7 patients suffering from small-for-size syndrome after a partial liver transplant. The findings are published in the February issue of Liver Transplantation. Abhinav Humar, MD, University of Minnesota, Minneapolis, Minnesota, and colleagues conducted a retrospective database analysis of all adult recipients of partial liver transplants at their centre between 1997 and 2007, to examine possible treatments for SFSS. A total of 100 patients received partial liver transplants, 7 of whom developed SFSS. Of the 7 patients, 5 underwent additional abdominal surgery within 2 weeks of their transplant, to rule out a technical complication of the transplant, and then to have their splenic artery ligated. The other 2 patients were treated radiologically by splenic artery coiling. "Of the 7 recipients, 6 had a good response to the splenic artery occlusion with improvement of liver function tests over the course of the next 1 to 2 weeks," the authors wrote. None developed post-operative spleen infections and all were alive and well after an average follow-up time of 3 years. One of the patients treated radiologically did not improve, and required a new transplant, which he received 3 months later. The doctors at the center eventually altered their approach in an attempt to prevent SFSS before it could happen. They performed splenic artery ligation at the time of transplantation in patients who had high portal vein pressure. While prevention of SFSS should be the goal, they said, this study indicates that occluding the splenic artery is a reasonable approach for treatment of established SFSS. "All except 1 of our recipients seemed to have a favourable response, and eventual complete normalisation of their liver function tests," the authors said. SOURCE: Wiley-Blackwell E-mail this page to a friend or colleague! To print, use this version