Successful Treatment of Hypersplenism in Wilson's Disease by Partial Splenic Embolization

Abstract

Aim: Hypersplenism can occur in patients with Wilson's disease (WD). Surgical splenectomy is a conventional treatment for this condition; however, emotional and neurological deterioration may follow splenectomy. In recent years, partial splenic embolization (PSE) has been increasingly performed as a nonsurgical alternative treatment for hypersplenism. The aim of this study was to evaluate the effectiveness and safety of PSE compared with splenectomy in the treatment of hypersplenism in WD patients. Methods: Fifty WD patients with hypersplenism were randomly divided into two groups (group A and group B), each including 25 patients. Patients in groups A and B were treated with PSE and splenectomy, respectively. Data were collected on the clinical efficacy of each procedure, adverse reactions, hematologic and blood chemistry test results, and abdominal computed tomography (CT) scan findings (group A only). Results: Marked improvements in the platelet and leukocyte counts after PSE and splenectomy were observed in all patients. PSE was associated with improved liver function without severe complications, and no significant changes in emotional and neurological symptoms were observed. In contrast, seven WD patients suffered neurological deterioration after splenectomy. Conclusions: Hypersplenism in WD patients was successfully treated by PSE, which appears to be a safe and effective alternative treatment for WD-induced hypersplenism.

Perioperative effects of desflurane versus propofol on hemostasis guided by thromboelastometry in splenectomy with liver cirrhosis

“…Patients with cirrhosis have impaired hemostasis which is multifactorial including impaired synthesis, function and clearance of coagulation factors as well as quantitative and qualitative platelet disorders. Accordingly, these patients suffer from bleeding or even thrombotic problems [1] in addition to a higher risk of bacterial infection secondary to the associated leucopenia [2].…”

Coronary artery bypass graft combined with liver transplantation in patients with advanced alcoholic liver cirrhosis: A case report

“…Postoperative decompensation of liver cirrhosis causes continuous production and outflow of pleural fluid, which can lead to slow wound recovery (19). Additionally, hypersplenism leads to severe leukopenia, anemia and other immune deficiencies, which can lead to secondary infections (20). Postoperative blood transfusion is also likely to induce hepatic encephalopathy and increase infection risk (21).…”

Liver stiffness assessed by real-time two-dimensional shear wave elastography predicts hypersplenism in patients with Wilson’s disease: a prospective study

“…3). The remaining 61 (67.8%) patients were continued to follow up without hypersplenism upon a median period of 22 months (range, [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24].…”

“…Therefore, it is of clinical importance to develop techniques to predict whether an individual WD patient will develop hypersplenism. Early intervention with splenic artery embolization can be used to decelerate hypersplenism progression [9].…”