The role of splenectomy before liver transplantation in biliary atresia patients

Yoshiaki Takahashi, Toshiharu Matsuura, Yusuke Yanagi, Koichiro Yoshimaru, Tomoaki Taguchi

研究成果: Contribution to journalArticle査読

2 被引用数 (Scopus)

抄録

Background/Purpose There is currently no unified view regarding whether liver transplantation or splenectomy should be performed for hypersplenism before liver transplantation in biliary atresia (BA) patients. We herein describe the efficacy of splenectomy before liver transplantation. Methods Splenectomy was performed in ten patients with hypersplenism associated with BA. We retrospectively reviewed their perioperative and postoperative courses, the number of leukocytes and thrombocytes, and the MELD score. Results The mean age was 17.5 ± 7.0 years (range 11–31 years), and the male-to-female ratio was 1:1. The platelet and leukocyte levels increased after splenectomy and returned to normal levels one month postoperatively. The mean MELD score after splenectomy was significantly decreased after splenectomy: 10 ± 2.1 vs 7.6 ± 1.8. In particular, PT-INR improved. Five patients underwent liver transplantation because of hepatopulmonary syndrome and repeated bouts of cholangitis, whereas the remaining five patients did not undergo liver transplantation because of improvements in the liver function (the mean follow-up period was 56 months). The postoperative complications included portal vein thrombosis and intestinal perforation, but the patient survival rates remained at 100%. Conclusion After splenectomy, both pancytopenia and the liver function clearly improved. Splenectomy should therefore be a treatment option for patients with hypersplenism before liver transplantation. Level of Evidence Retrospective Comparative Study – Level III.

本文言語英語
ページ(範囲)2095-2098
ページ数4
ジャーナルJournal of Pediatric Surgery
51
12
DOI
出版ステータス出版済み - 12 1 2016

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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