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

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.