Selective use of splenectomy after liver transplantation in children

Megison, Stephen M.; McMullin, Neil; Andrews, Walter S.

doi:10.1016/0022-3468(90)90196-g

Cited by 9 publications

(2 citation statements)

References 5 publications

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“…SPL has already been used in the past for immunologic reasons to improve graft survival in kidney transplantation [7]. In LTx, this procedure has been performed for therapeutic reasons to allow the use of azathioprine [8]. However, there is very little published literature about SPL and functional and life‐threatening disorders following LTx.…”

Section: Discussionmentioning

confidence: 99%

Functional, life‐threatening disorders and splenectomy following liver transplantation

Troisi¹,

Hesse²,

Decruyenaere

et al. 1999

Clinical Transplantation

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The lowering of the portal flow appears to resolve unexplained post-operative ascitic fluid loss as a result of functional graft congestion following LTx. However, because of the enhanced risk of SPL-related sepsis, a partial splenic embolization (PSE) or a spleno-renal shunt could be used as an alternative procedure because it allows us to preserve the immunological function of the spleen. SPL is indicated in case of post-transplant bleeding due to left-sided portal hypertension and trauma, spleen infarction, and to enable prevention of hemorrhage in liver transplant patients with multiple splenic artery aneurysms. Severe and persistent thrombocytopenia could be treated with PSE. Because the occurrence of fatal sepsis post-SPL is a major complication in LTx, functional disorders, such as ascites and thrombocytopenia, should be treated with a more conservative approach.

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Section: Discussionmentioning

confidence: 99%

Functional, life‐threatening disorders and splenectomy following liver transplantation

Troisi¹,

Hesse²,

Decruyenaere

et al. 1999

Clinical Transplantation

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“…It allowed patients to tolerate azathioprine therapy for episodes of rejection [6] . This practice continued until the early 1980s when cyclosporine was introduced.…”

Section: Splenectomymentioning

confidence: 99%

Treatment modalities for hypersplenism in liver transplant recipients with recurrent hepatitis C

Sibulesky

Nguyen

Paz‐Fumagalli

et al. 2009

WJG

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Hepatitis C is the most common indication for orthotopic liver transplantation in the United States. Unfortunately, hepatitis C recurs universally in the transplanted liver and is the major cause of decreased graft and patient survival. The combination therapy of interferon and ribavirin has been shown to be the most effective therapy for recurrent hepatitis C. However, pre-and post-transplant hypersplenism often precludes patients from receiving the antiviral therapy. Splenectomy and partial splenic embolization are the two invasive modalities that can correct the cytopenia associated with hypersplenism. In this report we review the two treatment options, their associated outcomes and complications.

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Effect of granulocyte colony-stimulating factor on neutropenia in liver transplant recipients with hypersplenism

Ishizone¹,

Makuuchi²,

Kawasaki³

et al. 1994

Journal of Pediatric Surgery

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Selective use of splenectomy after liver transplantation in children

Cited by 9 publications

References 5 publications

Functional, life‐threatening disorders and splenectomy following liver transplantation

Functional, life‐threatening disorders and splenectomy following liver transplantation

Treatment modalities for hypersplenism in liver transplant recipients with recurrent hepatitis C

Effect of granulocyte colony-stimulating factor on neutropenia in liver transplant recipients with hypersplenism

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