Long-term efficacy of partial splenic embolization in children.
OBJECTIVE
To elucidate the role of partial splenic embolization (PSE) procedures, long-term outcome was assessed in terms of the recurrence of thrombocytopenia.


METHODS
A retrospective study was performed after 41 PSE procedures in 36 patients for hypersplenism owing to portal hypertension. The underlying disease was biliary atresia in 32 patients, extrahepatic portal obstruction in 3, and idiopathic cirrhosis in 1.


RESULTS
The average volume embolized was 70.1%. The patients were followed up from 20 days to 182 months (average, 70.8 months). Five patients subsequently died, and 6 underwent liver transplantation. The causes of death or the reasons for liver transplantation were not related to hypersplenism. Eleven patients (30.6%) had recurrence of thrombocytopenia (<100,000/mm3). There was no significant difference in the volume embolized or platelet count before PSE between the patients with and without recurrence of thrombocytopenia. The peak value of platelet count after PSE was significantly lower in the patients with recurrence of thrombocytopenia (P =.0091). In 17 of 24 survivors without liver transplantation, platelet counts remained normal throughout the follow-up period.


CONCLUSIONS
PSE is a safe and effective procedure. Hematologic indices improved in all 36 patients after PSE, and its long-term efficacy was shown in 70% of the survivors.
Nio
Masaki
M
Department of Pediatric Surgery, Tohoku University School of Medicine, Sendai, Japan.
Hayashi
Yutaka
Y
Sano
Nobuyuki
N
Ishii
Tomohiro
T
Sasaki
Hideyuki
H
Ohi
Ryoji
R
D000293:Adolescent; D001656:Biliary Atresia / Q000150:complications / Q000401:mortality / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D001651:Cholestasis, Extrahepatic / Q000150:complications; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006971:Hypersplenism / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D006975:Hypertension, Portal / Q000150:complications*; D007223:Infant; D008103:Liver Cirrhosis / Q000150:complications; D016031:Liver Transplantation; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000209:etiology / Q000628:therapy*