Optimal changes in portal hemodynamics induced by splenectomy during living donor liver transplantation

Huanlin Wang, Toru Ikegami, Noboru Harada, Tomoharu Yoshizumi, Yuji Soejima, Hideaki Uchiyama, Yo Ichi Yamashita, Shinji Itoh, Norifumi Harimoto, Hirofumi Kawanaka, Ken Shirabe, Yoshihiko Maehara

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17 Citations (Scopus)

Abstract

Purposes: The purpose of this study was to evaluate the impact of splenectomy in adult-to-adult living donor liver transplantation (LDLT). Methods: Adult-to-adult LDLTs (n = 276) were divided into those with simultaneous splenectomy during LDLT (Splenectomy group, n = 154) and those without (Non-Splenectomy group, n = 122). Results: In the Splenectomy group, splenectomy decreased the portal venous pressure from 24.0 to 19.1 mmHg (p < 0.001). At the end of surgery, the portal venous pressure was significantly lower and the graft compliance was significantly higher in the Splenectomy group compared with the Non-Splenectomy group. The graft portal venous flow was also better in the Splenectomy group (y = 625–5.1x; r2 = 0.08, p < 0.01) than in the Non-Splenectomy group (y = 470–2.9x; r2 = 0.04, p = 0.03). Fourteen days after LDLT, the total bilirubin and ascites output were lower in the Splenectomy group than in the Non-Splenectomy group. Among the patients with hepatitis C, splenectomy was associated with a significantly higher rate of a sustained viral response (59.4 vs. 35.9 %, p = 0.020) than was noted in those without splenectomy (n = 39). There were no patients with post-splenectomy sepsis under vaccination. Conclusions: By decreasing the portal pressure and increasing the graft vascular compliance, splenectomy conferred better graft outcomes in adult-to-adult LDLT

Original languageEnglish
Pages (from-to)979-985
Number of pages7
JournalSurgery today
Volume45
Issue number8
DOIs
Publication statusPublished - Aug 23 2015

All Science Journal Classification (ASJC) codes

  • Surgery

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    Wang, H., Ikegami, T., Harada, N., Yoshizumi, T., Soejima, Y., Uchiyama, H., Yamashita, Y. I., Itoh, S., Harimoto, N., Kawanaka, H., Shirabe, K., & Maehara, Y. (2015). Optimal changes in portal hemodynamics induced by splenectomy during living donor liver transplantation. Surgery today, 45(8), 979-985. https://doi.org/10.1007/s00595-014-0999-9