Navigation Links
Help for liver transplant patients with small-for-size syndrome
Date:2/3/2009

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 (www.interscience.wiley.com).

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
medicalnews@bos.blackwellpublishing.com
781-388-8550
Wiley-Blackwell
Source:Eurekalert

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:
*Name:
*Comment:
*Email:
(Date:3/24/2017)... ... , ... According to a new study by NCPA Senior Fellow John R. ... rules Congress has directed the CBO to follow. The CBO itself previously recognized Obamacare ... it estimates a reduction in employer-based coverage due to the GOP reform, which is ...
(Date:3/24/2017)... ... ... The iaedp Foundation, the premier provider of educational programs and training standards for eating ... of disordered eating, announced today that the 2017 Symposium set a new attendance record ... countries converged on the Green Valley Resort in Las Vegas. , “We are ...
(Date:3/24/2017)... ... March 24, 2017 , ... ... Premier Center for Shamanic Healing and Spiritual Awakening, proudly presents her Sacred ... 2017. This sacred and spiritual journey during the Summer Solstice will also ...
(Date:3/24/2017)... ... March 24, 2017 , ... As ... to create a communications platform that positions them as the go-to thought leader ... reinvented their online publication as an always-on, always-fresh news, views and advocacy engine, ...
(Date:3/24/2017)... ... March 24, 2017 , ... On June ... ERISA Benefit Claims Litigation seminar in Chicago, Illinois. She will present on: ... of cases litigated under ERISA involve claims for long-term disability benefits. This ...
Breaking Medicine News(10 mins):
(Date:3/24/2017)... 23, 2017  HealthMine surveys with 9,250 insured consumers ... health plan members want help from their plans in ... in their health, 2) help closing gaps in care, ... health and 5) relevant, real-time guidance. Meeting these needs ... costs. A Reason to Stay ...
(Date:3/24/2017)... , March 23, 2017  Provectus Biopharmaceuticals, ... the "Company"), a clinical-stage oncology and dermatology biopharmaceutical ... Definitive Financing Commitment Term Sheet (the "Definitive Financing") ... group of the Company,s stockholders, who are referred ... in a Form 8-K filed with the Securities ...
(Date:3/24/2017)... 24, 2017 The Board of Directors of ... Report 2016 including the complete 2016 Annual Accounts with notes. ... Nordic Nanovector,s website in the section Investor Relations/Reports and presentations/Annual ... ... Kvåle, Chief Financial Officer Cell: +47-91-51-95-76 Email: ir@nordicnanovector.com ...
Breaking Medicine Technology: