Holger Michael Strunk MD, Presenter: Nothing to Disclose

Martin Wolff, Abstract Co-Author: Nothing to Disclose

Sebastian Flacke MD, Abstract Co-Author: Nothing to Disclose

To evaluate selective splenic artery occlusion in patients with impaired liver function tests after liver transplantation.

5 patients (2 male, 3 female; mean age 47 years) presented with a complicated course after liver transplatation and biochemical evidence of liver ichemia and failure. Transcatheter arterial embolization of splenohepatic steal syndrome with use of Gianturco coils or microcoils was performed, in three patients in addition dilatation of hepatic artery stenosis was carried out. Liver and spleen parenchyma were surveyed and evaluated before and after embolization with helical CT.

DSA examinations revealed a dilated splenic artery combined with a slightly decreased perfusion of the hepatic arteries. Sonography showed a marked elevated resistance index in the hepatic artery. Immediately after successful embolization a normal perfusion of the hepatic arteries could be noted. 4 Patients improved clinically within 24 hours of the procedure with significant change in biochemical and clinical parameters and normalisation of the hepatic artery resistance index. Splenic infarcts were observed in 4 patients. Normalisation of the hepatic artery resistance index persisted in the follow-up period up to 8 months and splenic infarcts resolved.

Splenic artery steal syndrome following liver transplantation surgery can be effectively treated by splenic artery embolization with coils. Successful embolization results in an improvement of organ perfusion with normalization of function tests.

Strunk, H, Wolff, M, Flacke, S, Arterial Steal Syndrome in Patients after Liver Transplantation: Transarterial Embolization of the Splenic Arteries.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4405136.html