title: Role of splenectomy in living-donor liver transplantation for adults.
abstract: OBJECTIVE
  Splenectomy is occasionally required in liver transplantation. However, its indications and drawbacks have not been clearly defined in living-donor liver transplantation.
  
  
  METHODS
  Eleven of 59 adult living-donor liver transplantation recipients underwent splenectomy. Indications were thrombocytopenia in 6 cases, portal flow disturbances due to splenorenal shunt in four, and splenic infarction in one. The incidence of bacterial complications and changes in platelet counts and portal vein flow were evaluated.
  
  
  RESULTS
  Two patients died of pneumonia and cerebral bleeding, respectively. Six events of bacterial infections occurred in the remaining nine patients. After splenectomy, a normal portal flow was achieved and the platelet count significantly increased.
  
  
  CONCLUSIONS
  Splenectomy may be an acceptable option in patients with thrombocytopenia or when it is necessary to change the portal flow.
authors.affiliation: Department of Surgery, Artificial Organ and Transplantation Division, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Matteo
authors.initials: M
authors.lastname: Cescon
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Tadatoshi
authors.initials: T
authors.lastname: Takayama
authors.forename: Yasuji
authors.initials: Y
authors.lastname: Seyama
authors.forename: Keiji
authors.initials: K
authors.lastname: Sano
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imamura
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Makuuchi
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000150:complications; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D013156:Splenectomy; D013921:Thrombocytopenia / Q000150:complications / Q000601:surgery*