title: Splenic Artery Syndrome after orthotopic liver transplantation: a review.
abstract: Splenic Artery Syndrome (SAS) has emerged as a controversial cause for graft ischemia in orthotopic liver transplant (OLTx) recipients. A complex combination of factors including hepatic artery hypoperfusion and portal hyperperfusion can result in SAS. Clinical and laboratory findings suggest graft ischemia but are generally non-specific. Conventional angiography findings of hepatic artery hypoperfusion with early and rapid filling of the splenic artery are suggestive of the diagnosis in the appropriate clinical setting. Treatment involves proximal splenic artery embolization, surgical splenic artery ligation, or in extreme cases, splenectomy. Most patients with SAS improve clinically following treatment. However, no randomized control trials are available to compare treatment options. Identification of at risk patients with pre-operative CT scans and intra-operative ultrasound has been proposed by some and may allow for prophylactic treatment of SAS.
authors.affiliation: University of Illinois Chicago, Metropolitan Group Hospitals, Department of Surgery, 836 W. Wellington Ave, Room 4807, Chicago, IL 60657, USA.
authors.forename: Soniya
authors.initials: S
authors.lastname: Pinto
authors.affiliation: Einstein Medical Center, Department of Radiology, 5501 Old York Road, Philadelphia, PA 19141, USA. Electronic address: reddyshi@einstein.edu.
authors.forename: Shilpa N
authors.initials: SN
authors.lastname: Reddy
authors.affiliation: Einstein Medical Center, Department of Radiology, 5501 Old York Road, Philadelphia, PA 19141, USA.
authors.forename: Mindy M
authors.initials: MM
authors.lastname: Horrow
authors.affiliation: University of Toledo, Department of Surgery and Transplant, 2801 W B Bancroft St., Toledo, OH 43606, USA.
authors.forename: Jorge
authors.initials: J
authors.lastname: Ortiz
mesh_terms: D006499:Hepatic Artery / Q000502:physiology*; D006801:Humans; D007511:Ischemia / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D008107:Liver Diseases / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D012039:Regional Blood Flow / Q000502:physiology; D013157:Splenic Artery / Q000502:physiology*; D013577:Syndrome; D019737:Transplants / Q000098:blood supply*
keywords: Hypoperfusion; Liver; Splenic; Steal; Transplant