The impact of splenectomy or splenic artery ligation on the outcome of a living donor adult liver transplantation using a left lobe graft

Mitsuo Shimada, Hideki Ijichi, Yusuke Yonemura, Noboru Harada, Satoko Shiotani, Mizuki Ninomiya, Takahiro Terashi, Tomoharu Yoshizumi, Yuji Soejima, Taketoshi Suehiro, Yoshihiko Maehara

Research output: Contribution to journalArticle

103 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)625-629
Number of pages5
JournalHepato-gastroenterology
Volume51
Issue number57
Publication statusPublished - May 1 2004

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Splenic Artery
Living Donors
Splenectomy
Liver Transplantation
Ligation
Transplants
Ascites
Hypersplenism
Portal Pressure
Hyperbilirubinemia
Esophageal and Gastric Varices
Cholestasis
Portal Vein
Platelet Count
Leukocyte Count
Aneurysm
Survival Rate
Weights and Measures
Incidence

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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The impact of splenectomy or splenic artery ligation on the outcome of a living donor adult liver transplantation using a left lobe graft. / Shimada, Mitsuo; Ijichi, Hideki; Yonemura, Yusuke; Harada, Noboru; Shiotani, Satoko; Ninomiya, Mizuki; Terashi, Takahiro; Yoshizumi, Tomoharu; Soejima, Yuji; Suehiro, Taketoshi; Maehara, Yoshihiko.

In: Hepato-gastroenterology, Vol. 51, No. 57, 01.05.2004, p. 625-629.

Research output: Contribution to journalArticle

Shimada, M, Ijichi, H, Yonemura, Y, Harada, N, Shiotani, S, Ninomiya, M, Terashi, T, Yoshizumi, T, Soejima, Y, Suehiro, T & Maehara, Y 2004, 'The impact of splenectomy or splenic artery ligation on the outcome of a living donor adult liver transplantation using a left lobe graft', Hepato-gastroenterology, vol. 51, no. 57, pp. 625-629.
Shimada, Mitsuo ; Ijichi, Hideki ; Yonemura, Yusuke ; Harada, Noboru ; Shiotani, Satoko ; Ninomiya, Mizuki ; Terashi, Takahiro ; Yoshizumi, Tomoharu ; Soejima, Yuji ; Suehiro, Taketoshi ; Maehara, Yoshihiko. / The impact of splenectomy or splenic artery ligation on the outcome of a living donor adult liver transplantation using a left lobe graft. In: Hepato-gastroenterology. 2004 ; Vol. 51, No. 57. pp. 625-629.
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AU - Harada, Noboru

AU - Shiotani, Satoko

AU - Ninomiya, Mizuki

AU - Terashi, Takahiro

AU - Yoshizumi, Tomoharu

AU - Soejima, Yuji

AU - Suehiro, Taketoshi

AU - Maehara, Yoshihiko

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