title: Characteristics and management of splenic artery aneurysm in liver transplant candidates and recipients.
abstract: The incidence of splenic artery aneurysm (SAA) in patients with cirrhosis ranges from 7 per cent to 17 per cent. SAA rupture after liver transplantation (LT) is reported to result in significant morbidity and mortality. We report our experience with SAA in LT candidates. From September 1995 through August 2002, 14 LT candidates were diagnosed with SAA. Twenty SAA occurred in 14 patients with an average diameter of 20 mm. Eleven patients qualified for LT; to date, seven have been transplanted. No intervention for SAA occurred prior to LT. Of the seven patients transplanted, four had SAA identified prior to LT. Three were treated at LT and are alive; the fourth had postoperative splenic artery embolization followed by splenectomy and expired on day 109 from duodenal ulcer complications. Three of seven patients had undiagnosed SAA at LT. One required emergency splenectomy for SAA rupture and is alive at 44 months. The remaining two received no treatment; one suffered a late septic death and one is alive at 15 months. No ruptures occurred in our pre-LT population, suggesting that definitive management can await LT. We recommend that all patients undergo four-phase computed tomography or magnetic resonance angiography (MRA) as part of the LT evaluation and that identified SAA be resected at transplantation.
authors: University of Southern California, Keck School of Medicine, Los Angeles, California, USA.
authors: Gregory
authors: G
authors: Heestand
authors: Linda
authors: L
authors: Sher
authors: Johnson
authors: J
authors: Lightfoote
authors: Suzanne
authors: S
authors: Palmer
authors: Rod
authors: R
authors: Mateo
authors: Gagandeep
authors: G
authors: Singh
authors: Jennifer
authors: J
authors: Moser
authors: Rick
authors: R
authors: Selby
authors: Yuri
authors: Y
authors: Genyk
authors: Nicolas
authors: N
authors: Jabbour
mesh_terms: D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery; D016031:Liver Transplantation; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013156:Splenectomy; D013157:Splenic Artery; D014057:Tomography, X-Ray Computed