Safety and efficacy of splenic artery embolization for portal hyperperfusion in liver transplant recipients: A 5‐year experience
| Autor: | Masato Fujiki, Federico Aucejo, Charles Miller, Weiping Wang, Koji Hashimoto, Qiang Liu, Charles Winans, Naftali Presser, Cynthia Tom, Teresa Diago-Uso, Dympna Kelly, Bijan Eghtesad, Cristiano Quintini |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Time Factors medicine.medical_treatment Hemodynamics Splenic artery Liver transplantation Gastroenterology Liver disease Postoperative Complications medicine.artery Internal medicine parasitic diseases medicine Humans Embolization Ultrasonography Doppler Color Portography Ohio Retrospective Studies Transplantation Hepatology medicine.diagnostic_test business.industry medicine.disease Embolization Therapeutic Liver Transplantation Portal System Treatment Outcome medicine.anatomical_structure Hydrothorax Surgery business Splenic Artery Liver Circulation Artery |
| Zdroj: | Liver Transplantation. 21:435-441 |
| ISSN: | 1527-6473 1527-6465 |
| Popis: | Severe portal hyperperfusion (PHP) after liver transplantation has been shown to cause intrahepatic arterial vasoconstriction secondary to increased adenosine washout (hepatic artery buffer response). Clinically, posttransplant PHP can cause severe cases of refractory ascites and hydrothorax. In the past, we reported our preliminary experience with the use of splenic artery embolization (SAE) as a way to reduce PHP. Here we present our 5-year experience with SAE in orthotopic liver transplantation (OLT). Between January 2007 and December 2011, 681 patients underwent OLT at our institution, and 54 of these patients underwent SAE for increased hepatic arterial resistance and PHP (n=42) or refractory ascites/hepatic hydrothorax (n=12). Patients undergoing SAE were compared to a control group matched by year of embolization, calculated Model for End-Stage Liver Disease score, and liver weight. SAE resulted in improvements in hepatic artery resistive indices (0.92±0.14 and 0.76±0.10 before and after SAE, respectively; P |
| Databáze: | OpenAIRE |
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