Navigation Links
Help for liver transplant patients with small-for-size syndrome

Blocking off the splenic artery, either through surgical ligation or radiological coiling, helped six out of seven patients suffering from small-for-size syndrome after a partial liver transplant. This finding is in the February issue of Liver Transplantation, a journal published by John Wiley & Sons. The article is also available online at Wiley Interscience (

Due to the shortage of liver donors, and the long list of patients in need of a transplant, doctors are increasingly using partial grafts. They may take half of the liver from a living donor, or split the liver of a deceased donor into two usable parts. These techniques have increased the number of transplants being performed; however, they have also led to new problems, such as small-for-size syndrome (SFSS), in which the new liver can't handle the metabolic demands of the recipient.

The syndrome causes liver dysfunction soon after the transplant; symptoms include problems with bile flow and coagulation, and ascites, which is the accumulation of fluid in the abdomen. Without treatment, about 50 percent of patients with SFSS will die of sepsis or another complication. Fortunately, there are ways to treat the condition, although the best approach is unclear.

To examine possible treatments for SFSS, researchers, led by Abhinav Humar of the University of Minnesota, conducted a retrospective database analysis of all adult recipients of partial liver transplants at their center between 1997 and 2007. There were 100 such patients, seven of whom developed SFSS. Five of the seven underwent additional abdominal surgery within two weeks of their transplant, to rule out a technical complication of the transplant, and then to have their splenic artery ligated. The other two patients were treated radiologically by splenic artery coiling.

"Of the seven recipients, six had a good response to the splenic artery occlusion with improvement of liver function tests over the course of the next one to two weeks," the authors report. None developed post-operative spleen infections and all were alive and well after an average follow-up time of three years. One of the patients treated radiologically did not improve, and required a new transplant, which he received three months later.

The doctors at the center eventually altered their approach in an attempt to prevent SFSS before it could happen. They performed splenic artery ligation at the time of transplantation in patients who had high portal vein pressure.

While prevention of SFSS should be the goal, they say, this study indicates that occluding the splenic artery is a reasonable approach for treatment of established SFSS. "All except one of our recipients seemed to have a favorable response, and eventual complete normalization of their liver function tests," they report.

An accompanying editorial by Chung Mau Lo of Hong Kong, emphasizes the need for a consensus on how to diagnose SFSS. As for treating this condition, he supports the conclusions of Humar and colleagues.

He advocates routine monitoring of portal pressure and flow in high-risk partial liver transplant recipients. "Portal flow modulation such as splenic artery ligation should be done early rather than delayed," Lo writes.


Contact: Sean Wagner

Related medicine news :

1. Advanced Age No Bar to Liver Transplant
2. Researchers Find Better Way to Deliver Blood Thinner
3. Federal research plan to determine nanotech risks fails to deliver
4. Liver cancer marker could yield blood test for early detection
5. Blood Marker Might Help Spot Early Liver Cancer
6. Natural Protein Could Help Spot, Treat Liver Cancer
7. Diet Change Can Curb Fatty Liver Disease
8. US FDA Fast Tracks PI-88 for the Treatment of Post Resection Liver Cancer
9. The American Liver Foundation Appoints Rick Smith, a Twenty-Year Veteran of The MS Society, as Chief Executive Officer
10. Re-plumbing liver helps beat cancer
11. Free Prescription Drug Program Uses Internet to Deliver Cards - Offers Assistance to Uninsured
Post Your Comments:
(Date:11/25/2015)... (PRWEB) , ... November 25, 2015 , ... “While riding ... an inventor, from Bronx, N.Y. “I thought there had to be a convenient and ... the PROTECTOR. , The PROTECTOR enables disabled individuals to safely travel during cold or ...
(Date:11/25/2015)... ... November 25, 2015 , ... "When I underwent ... bras were incredibly uncomfortable," said an inventor from Bronx, N.Y. "In order to ... the patent-pending RECOVERY BRA for added comfort and support. The bra is easier ...
(Date:11/25/2015)... ... November 25, 2015 , ... Bcureful—a ... (TSC), as well as raising public awareness of the disorder while helping to ... third donation of $35,000 to bolster progress at the Tuberous Sclerosis Complex Center ...
(Date:11/24/2015)... ... November 25, 2015 , ... Genesis Chiropractic Software helps practice ... an agreement between the practice owner and the patient that automatically manages all ... projections. Click here to learn more. , According to ...
(Date:11/24/2015)... ... November 24, 2015 , ... Young patients with a wide variety of dental ... Dr. Kedar S. Lele, who are pediatric dentists in Tucson, AZ . Unlike ... iPlus 2.0™ system causes minimal discomfort and bleeding to the patient during treatment and ...
Breaking Medicine News(10 mins):
(Date:11/24/2015)... , November 24, 2015 ... --> adds Latest Guidebook for ... of 217 pages published in November 2015 to ... online business intelligence library at . ... of the fastest growing global economies with a ...
(Date:11/24/2015)... 24, 2015  Ascendant Solutions, Inc. (Pink Sheets: ASDS ... of Directors has declared a special 1 percent stock dividend ... payable December 14, 2015, to shareholders of record December 7, ... additional shares of common stock. --> ... a strong endorsement of our confidence in Ascendant,s growth strategy ...
(Date:11/24/2015)... Nov. 24, 2015 Diplomat Pharmacy, Inc. (NYSE: DPLO) ... of Clinical Services, Education and Human Resources will be presenting ... Oncology Drugs: Health Plan Strategies for a Dynamic Market" on ... Fenrick , a consultant with the Cambridge Advisory Group, where ... The webinar will discuss the rapid growth ...
Breaking Medicine Technology: