title: Effect of liver transplantation on spleen size, collateral veins, and platelet counts.
abstract: BACKGROUND
  The aim of this study was to evaluate the effect of liver transplantation on the spleen size, spontaneous splenorenal shunt (SRS) function, and platelet counts in patients with hypersplenism.
  
  
  METHODS
  Between December 2001 and February 2007, 462 adult patients underwent orthotopic liver transplantations (OLTX) at our institution. Of these patients, CT or MRI information was reviewed retrospectively in 55 patients. Volume measurements of the spleen and liver, spleen/liver volume ratio (S/L ratio), presence and size of SRS, and platelet counts were evaluated before and after OLTX.
  
  
  RESULTS
  Mean spleen volume decreased from 827 +/- 463 ml to 662 +/- 376 ml after OLTX (p < 0.01). Five (11%) patients returned to normal-range spleen size after OLTX. SRS was observed in 19 patients before OLTX (35%). The diameter of SRS also significantly decreased from 1.0 +/- 0.5 cm before OLTX to 0.7 +/- 0.5 cm after OLTX (p < 0.05). SRS disappeared in 16% of patients (3/19). S/L ratio significantly decreased from 0.65 +/- 0.33 to 0.38 +/- 0.17 (p < 0.01) after OLTX. Platelet counts significantly increased after OLTX (p < 0.01). Improvement of the platelet count in the group with postoperative S/L ratio >0.35 was not as good as that in the group with S/L ratio <0.35 (p < 0.01).
  
  
  CONCLUSIONS
  Spleen size and SRS size became significantly smaller after OLTX. However, patients with postoperative S/L ratio >0.35 tend to have lower platelet counts after OLTX.
authors.affiliation: Miami Transplant Institute, Division of Liver and GI Transplantation, Department of Surgery, University of Miami Miller School of Medicine, Highland Professional Bldg., 1801 NW 9th Avenue, 3rd Floor, Miami, FL 33136, USA. chikamo1@i-kochi.or.jp
authors.forename: Fumio
authors.initials: F
authors.lastname: Chikamori
authors.forename: Seigo
authors.initials: S
authors.lastname: Nishida
authors.forename: Gennaro
authors.initials: G
authors.lastname: Selvaggi
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Tryphonopoulos
authors.forename: Jang I
authors.initials: JI
authors.lastname: Moon
authors.forename: David M
authors.initials: DM
authors.lastname: Levi
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Kato
authors.forename: Eddie R
authors.initials: ER
authors.lastname: Island
authors.forename: Akira
authors.initials: A
authors.lastname: Maki
authors.forename: Akin
authors.initials: A
authors.lastname: Tekin
authors.forename: Andreas G
authors.initials: AG
authors.lastname: Tzakis
mesh_terms: D016009:Chi-Square Distribution; D003097:Collateral Circulation; D005260:Female; D006801:Humans; D008099:Liver / Q000033:anatomy & histology* / Q000098:blood supply; D016031:Liver Transplantation; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010976:Platelet Count; D012189:Retrospective Studies; D013154:Spleen / Q000033:anatomy & histology* / Q000098:blood supply; D013164:Splenorenal Shunt, Surgical; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed