Document Detail


The impact of splenectomy or splenic artery ligation on the outcome of a living donor adult liver transplantation using a left lobe graft.
MedLine Citation:
PMID:  15143878     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: The aim of this study was to clarify the impact of splenectomy or splenic artery ligation on the outcome in living donor adult liver transplantation (LDALT) using a left lobe graft. METHODOLOGY: Forty-eight LDALT cases using a left lobe graft were enrolled in this study. The patients were classified into two groups: Group A (n=40), in which neither a splenectomy nor a splenic artery ligation was performed, and Group B (n=8), in which a splenectomy (n=6) or a splenic artery ligation (n=2) was performed. Indications for splenectomy were as follows: 1) demonstrating a hypersplenism and/or 2) having splenic aneurysms. RESULTS: None of the patients receiving a splenectomy or a splenic artery ligation experienced any septic complication in this series. The graft-recipient weight ratio in group B tended to be smaller than in group A. In group B, all patients were classified into Child's class C or B. The incidence of esophageal varices in group B was significantly higher than in group A. Moreover, the platelet count and the white blood cell count in group B were significantly lower than in group A. No statistical difference was found in postoperative functional cholestasis and intractable ascites. None of the participants in group B experienced both postoperative hyperbilirubinemia and intractable ascites, which were characterized as a small-for-size graft after LDALT. The patient survival rate in group B seems to be better than in group A. In a majority of the cases the portal pressure as well as the portal vein flow after a splenectomy decreased in comparison to that before the splenectomy. CONCLUSIONS: Splenectomy or splenic artery ligation is considered to be beneficial for improving the outcome in LDALT using a left lobe graft.
Authors:
Mitsuo Shimada; Hideki Ijichi; Yusuke Yonemura; Noboru Harada; Satoko Shiotani; Mizuki Ninomiya; Takahiro Terashi; Tomoharu Yoshizumi; Yuji Soejima; Taketoshi Suehiro; Yoshihiko Maehara
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  51     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2004 May-Jun
Date Detail:
Created Date:  2004-05-17     Completed Date:  2004-07-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  625-9     Citation Subset:  IM    
Affiliation:
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. mshimada@surg2.med.kyushu-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Humans
Ligation
Liver Transplantation / methods*
Living Donors
Male
Middle Aged
Splenectomy*
Splenic Artery*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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