Year 2018 / Volume 110 / Number 4
Case Report
Complete splenic embolization for the treatment of refractory ascites after liver transplantation

257-259

DOI: 10.17235/reed.2018.5338/2017

Oana Anisa Nutu, Iago Justo Alonso, Alberto Alejandro Marcacuzco Quinto, Jorge Calvo Pulido, Luis Carlos Jiménez Romero,

Abstract
Refractory ascites is an uncommon complication that may develop postoperatively after liver transplantation. The diagnosis and treatment of this condition is a real challenge. We report two cases of patients who underwent a transplant due to cryptogenic cirrhosis and developed refractory ascites during the immediate postoperative period. This is a serious complication associated with decreased survival by up to one year and a reduced quality of life. After ruling out the main causes of ascites, a portal hyperflow was a potential etiology. This condition perpetuates itself with splenic circulation and brings about a reduction in the hepatic arterial flow. Therefore, if arterial blood flow to the spleen is diminished, venous return and portal circulation will be reduced and arterial blood flow will improve. Splenic artery embolization is a procedure introduced many years ago for the management of splenic artery steal syndrome and small-for-size living donor liver transplantation. This procedure is performed in order to reduce portal hyperflow and consequently, ascites. In conclusion, splenic artery embolization is a therapeutic option for the treatment of refractory ascites after liver transplantation.
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References
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Nutu O, Justo Alonso I, Marcacuzco Quinto A, Calvo Pulido J, Jiménez Romero L. Complete splenic embolization for the treatment of refractory ascites after liver transplantation. 5338/2017


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Publication history

Received: 25/10/2017

Accepted: 01/12/2017

Online First: 07/02/2018

Published: 02/04/2018

Article revision time: 34 days

Article Online First time: 105 days

Article editing time: 159 days


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