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

nic 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.


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

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