Partial splenic embolization: 12-month hematological effects and complications.
OBJECTIVE
To investigate the hematological effects and immediate postoperative complications of partial splenic embolization (PSE) in patients with liver cirrhosis.


METHODS
Record of liver cirrhosis patients with thrombocytopenia and leukopenia in whom PSE was performed between June 1995 and June 2005 were reviewed. Peripheral blood counts were evaluated at baseline, at 1 week, and at months 1, 3, 6, and 12 months post-PSE and clinically significant complications were recorded.


RESULTS
In the twenty patients who underwent PSE, significant improvements in thrombocyte and leukocyte levels were noted at all time points compared to baseline levels up to one year following PSE (P<0.01). The complication rate was 100% because all patients experienced fever and abdominal pain. Only 7 patients (35%) experienced additional, mild post-embolization complications, and only 2 (10%) experienced serious complications. The mortality rate in this study was 0%.


CONCLUSIONS
PSE significantly improved thrombocytopenia and leukopenia. These results support the contention that PSE is effective and safe, and should be employed more widely in the management of thrombocytopenia in patients with liver cirrhosis, particularly higher-risk patients that may not be candidates for surgical splenectomy. Further studies evaluating risk factors, criteria for patient selection, and target embolization area are warranted.
Wang
Horng-Yuan
HY
Division of Gastroenterology and Hepatology, Mackay Memorial Hospital, Mackay Medicine, Nursing and Management College, Taipei, Taiwan. hywang.peter@msa.hinet.net
Shih
Shou-Chuan
SC
Lin
Shee-Chan
SC
Chang
Wen-Shiung
WS
Wang
Tsang-En
TE
Lin
Fung J
FJ
Yang
Fei-Shih
FS
D000328:Adult; D000368:Aged; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008103:Liver Cirrhosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D013157:Splenic Artery