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ECR 2019 / C-2984
Imaging Findings, Diagnostic and Treatment Options of Post-transplant Non-occlusive Hepatic Artery Hypoperfusion (Splenic Steal) Syndrome
Congress: ECR 2019
Poster No.: C-2984
Type: Educational Exhibit
Keywords: Transplantation, Ischaemia / Infarction, Haemodynamics / Flow dynamics, Embolisation, Contrast agent-intravenous, Arterial access, Ultrasound-Colour Doppler, Percutaneous, Catheter arteriography, Spleen, Liver, Interventional vascular
Authors: D. Vas, Á. García-Criado, F. M. Gómez, M. Barrufet, M. Burrel; Barcelona/ES
DOI:10.26044/ecr2019/C-2984

Conclusion

 

Conclusion

  • Splenic steal syndrome is an uncommon, probably under-recognized vascular complication after liver transplant.

 

  •  Clinical suspicion is raised in case of liver enzyme elevation, altered arterial resistive index detected on post-transplant follow up Doppler ultrasound with patent hepatic artery and portal permeability in the absence of other clinical or histopathological cause of graft failure.

 

  • In such cases, prompt diagnostic/therapeutic arteriography should be performed of the celiac axis. Findings of delayed hepatic arteriogram, large splenic artery diameter, decreased HA/SA diameter ratio, splenomegaly could support diagnostic suspicion

 

  • Transcatheter embolization of the proximal SA is an effective treatment of SSS with low complication rate. If not feasible, surgical banding or ligation of the SA can be an alternative
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