Year 2018 / Volume 110 / Number 4
Case Report
Complete splenic embolization for the treatment of refractory ascites after liver transplantation

257-259

DOI: 10.17235/reed.2018.5338/2017

Oana Anisa Nutu, Iago Justo Alonso, Alberto Alejandro Marcacuzco Quinto, Jorge Calvo Pulido, Luis Carlos Jiménez Romero,

Abstract
Refractory ascites is an uncommon complication that may develop postoperatively after liver transplantation. The diagnosis and treatment of this condition is a real challenge. We report two cases of patients who underwent a transplant due to cryptogenic cirrhosis and developed refractory ascites during the immediate postoperative period. This is a serious complication associated with decreased survival by up to one year and a reduced quality of life. After ruling out the main causes of ascites, a portal hyperflow was a potential etiology. This condition perpetuates itself with splenic circulation and brings about a reduction in the hepatic arterial flow. Therefore, if arterial blood flow to the spleen is diminished, venous return and portal circulation will be reduced and arterial blood flow will improve. Splenic artery embolization is a procedure introduced many years ago for the management of splenic artery steal syndrome and small-for-size living donor liver transplantation. This procedure is performed in order to reduce portal hyperflow and consequently, ascites. In conclusion, splenic artery embolization is a therapeutic option for the treatment of refractory ascites after liver transplantation.
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References
1. Quintini C, D’Amico G, Brown C, et al. Splenic artery embolization for the treatment of refractory ascites after liver transplantation. Liver trans 2011; 17: 668-673
2. Pravisani R, Baccarani U, Adani G, et al. Splenic artery syndrome as a possible cause of late onset refractory ascites after liver transplantation: management with proximal splenic artery embolization. Transplantation Proc 2016; 48: 377-379
3. Gotthardt D, Weiss K, Rathenberg V, et al. Persistent ascites after liver transplantation: etiology, treatment and impact on survival. Ann Transplan 2013; 18: 378-383
4. Arroyo V, Gines P, Gerbes AL et al. Definition and diagnostic criteria of refractory ascites and hepatorenal síndrome in cirrosis. Hepatology 1996; 23: 164-176
5. Presser N, Quintini C, Tom C, et al. Safety and efficacy of splenic artery embolization for portal hyperperfusion in liver transplant recipients: a 5 year experience. Liver trans 2015; 21:435-441
6. Eipel C, Abshagen K, Vollmar B. Regulation of hepatic blood flow: The hepatic arterial buffer response revisited. World J Gastroenterol 2010; 16: 6046-6057
7. Zhou Zhu K, Meng X, Qian J, et al. Partial splenic embolization for hypersplenism in cirrhosis: a long-term outcome in 62 patients. Dig Liver Dis 2009; 41: 411-416
8. Noghuci Noguchi H, Hirai K, Aoki Y, et al. Changes in platelet kinetics after a partial splenic arterial embolization in cirrhotic patients with hypersplenism. Hepatology 1995; 22: 1682-1688
9. Kim H, Suh K, Jeon Y, et al. Partial splenic artery embolization for thrombocytopenia and uncontrolled massive ascites after liver transplantation. Transplant Proc 2012; 44: 755-756
10. Meighani A, Jafri S, Raoufi M, et al. Splenic artery embolization for treatment of refractory ascites after liver transplantation. ACG Case Rep J 2016; 3:136-138
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Nutu O, Justo Alonso I, Marcacuzco Quinto A, Calvo Pulido J, Jiménez Romero L. Complete splenic embolization for the treatment of refractory ascites after liver transplantation. 5338/2017


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Publication history

Received: 25/10/2017

Accepted: 01/12/2017

Online First: 07/02/2018

Published: 02/04/2018

Article revision time: 34 days

Article Online First time: 105 days

Article editing time: 159 days


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