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Clinical Characteristics of Splenic Artery Steal Syndrome After Orthotopic Liver Transplantation

li na   

  • Received:2010-04-19 Revised:2010-06-24 Published:2010-11-15 Online:2010-11-15
  • Contact: li na

Abstract: Objective: to analyze the clinical characteristics, diagnosis and treatment methods and therapeutic effect of splenic artery steal syndrome. Methods: Retrospective clinical observational cases. All patients with splenic artery steal syndrome underwent examinations with blood routine, liver function, color Doppler image, and celiac angiogram. Results: Eight patients with splenic artery steal syndrome were examined. There were 6 case males and 2 case females. The age of these patients ranged from 22 to 55 years, average 43.9 years. The time of final diagnosis ranged from 4 to 30 days. Clinical signs included hypersplenism and elevated liver enzymes. Color Doppler image showed low hepatic artery velocity and high resistance index. Celiac angiogram showed the hepatic artery was patent but presented with sluggish flow, delayed filling of intrahepatic arterial branches, poor peripheral parenchymal perfusion, associated with early and abundant filling and of the splenic artery. All patients were treated by splenic arterial embolization with coils. The 8 patients improved quickly with significant change in the biochemical and clinical parameters. There were no complications during follow-up period. Conclusion: Splenic artery steal syndrome has low incidence rate. Clinical signs include hypersplenism and elevated liver enzymes. Color Doppler image can be used to screen the patients with splenic artery steal syndrome. Celiac angiogram can be used to diagnose the patients with splenic artery steal syndrome. The patients with splenic artery steal syndrome can be effectively treated by splenic artery embolization with coils.

Key words: orthotopic liver transplantation, splenic artery steal syndrome, color Doppler image, celiac angiogram, transcatheter splenic artery occlusion