Splenic embolization in treatment of portal vein occlusion deferring liver transplantation.
The number of liver transplantations performed in this country is limited to the availability of cadaver liver donors, which are always short of demand. Deterioration of patient's clinical condition during the long wait for a compatible donor usually casts a poor prognosis on the patient. We report a 6-year-old girl who underwent splenic artery embolization as an alternative procedure due to a life-threatening clinical condition while liver graft was not immediately available. She was a case of idiopathic portal hypertension with portal vein occlusion that had resulted in splenomegaly, pancytopenia, gastric and esophageal varices. Living graft transplantation was contraindicated due to portal vein lesion. She was listed as high-urgency for liver transplantation as she developed repeated esophageal variceal bleeding requiring frequent sclerotherapy and admission to the intensive care unit. Prevention of the ongoing worsening clinical complications, improvement of hematological disorders and correction of hypersplenism was achieved right after splenic artery embolization. The patient resumed normal daily life and has been successfully eliminated from the waiting list of liver transplantation. We conclude that this is a safe and effective alternative to splenectomy that might call of further liver transplantation.
Department of Diagnostic Radiology, Liver Transplant Program, Chang Gung University, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83305, Taiwan. cheng.yufan@msa.hinet.net
Yu Fan
YF
Cheng
Chao Long
CL
Chen
Tai Yi
TY
Chen
Tung Liang
TL
Huang
Yaw Sen
YS
Chen
Leo Leung-chit
LL
Tsang
Po Lin
PL
Sun
D002648:Child; D000075202:Contraindications; D004621:Embolization, Therapeutic; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000628:therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D016031:Liver Transplantation; D011169:Portal Vein; D013157:Splenic Artery