Splenic Artery Embolization for Splenic Artery Steal Syndrome After Living Donor Liver Transplantation: A Case Report

Abstract

Splenic artery steal syndrome (SASS) has been considered a life-threatening complication to liver transplant recipients. Herein we timely diagnosed a case of SASS with deteriorating liver function. SASS was screened by routine Doppler ultrasonography (DUS) and multidetector computed tomography and was ultimately diagnosed by selective celiac trunk angiography. The patient was rescued by splenic artery embolization. In this case, routine DUS was useful to screen SASS. Signs of high-resistance hepatic artery waveform and low diastolic flow were highly suspected of SASS. This case also indicated that portal hyperperfusion was a cause of graft dysfunction in SASS. The study was in accordance with the Helsinki Congress and the Declaration of Istanbul, no prisoners were used, and participants were neither paid nor coerced in this study. Furthermore, we reviewed the recent literatures on the advances in the diagnosis and treatment of SASS. These studies suggest that splenic artery embolization may be a safe and effective technique to treat SASS. In addition, identification of recipients at high risk of SASS with preoperative computed tomography scans and DUS is recommended. Banding or ligation the splenic artery may be useful to prevent SASS and other potential complications after liver transplantation.