Treatment of hypersplenism in perioperation of liver transplantation

    JIANG An, L¦a Yi, LIU Chang, LI Zongª²Fang, LI Quanª²Yuan, SHI Yuan, MA Feng

    Department of Hepatobiliary Surgery, First Affiliated Hospital, General Surgeon Department of VIP Clinic, Second Affiliated Hospital, Xi¬ðan Jiaotong University, Xi¬ðan 710004, China, Xi¬ðan Jiaotong University, Xi¬ðan 710061, China

    ¡¾Abstract¡¿AIM: To observe the changes in hypersplenism after orthotopic liver transplantation(OLT)and to investigate the influence of splenectomy or splenic artery ligation before or during liver transplantation on the therapeutic outcome. METHODS: Splenectomy or splenic artery ligation was performed on 15(group A) of the consecutive 115 patients undergoing OLT in 5 years, before OTC in 11 of them and during OTC in 4 of them. Sixtyª²eight randomly selected ageª²matched patients undergoing OTC within the same period but without splenectomy or splenic artery ligation were used as controls (group B). Acute rejection rate , blood PLT count, incidence of lung infection and PVF/HAF(portal venous flow/ hepatic arterial flow) were calculated and analyzed. RESULTS: Lung infaction rate of group A was 85%, significantly higher than that of group B (54%, P<0.05); acute rejection did not occur in group A, but in 10 cases of group B(15%), however, without significant differences between them; blood PLT peak level of group A was (340¡À158)¡Á109/L, significantly higher than that of group B[(249¡À93)¡Á109/L, P<0.01]; blood PLT count reached the peak level 25 d after the operation in group A, and 21 d in group B; no significant difference between them; PVF/PAF was 12¡À8 in group A ......