Effect of preoperative splenectomy on liver transplantation in treatment of portal hypertension
10.3760/cma.j.issn.1007-8118.2014.08.006
- VernacularTitle:术前脾切除对肝移植治疗门脉高压症的影响
- Author:
Jingyu CHEN
;
Yi JIANG
;
Xiaojin ZHANG
- Publication Type:Journal Article
- Keywords:
Hypertension,portal;
Liver transplantation;
Splenectomy;
Infection;
Platelets
- From:
Chinese Journal of Hepatobiliary Surgery
2014;20(8):572-576
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the influence of preoperative splenectomy on liver transplantation for portal hypertension and the management of complications.Methods From January 2008 to January 2013,a total of 136 patients underwent liver transplantation for portal hypertension (PHT) in Hepatobiliary Surgery Center,Fuzhou General Hospital of PLA Nanjing Military Region.Pre-liver transplantation splenectomy was carried out in 19 patients.We randomly selected according to the operation time 50 cases of liver transplantation as the control group.The operation time,bleeding,blood transfusion,infection,the incidence of acute rejection,biliary complication rate,survival rate,postoperative platelet recovery and arteriovenous thrombosis were analyzed.Results The preoperative group has longer surgical time,intraoperative blood loss,blood transfusion volume increased obviously,infection rate increased significantly compared with the control group.The accumulate survival rate of preoperative splenectomy group was significantly lower than that of the control group.The platelet count of the preoperative splenectomy group was significantly higher than that of the control group.The platelet count of both groups experienced the process of first rise after falling.Although the platelet count of the preoperative splenectomy group was higher than that of the control group,but there was no statistically significant difference.Conclusions Liver transplantation in PHT patients with previous splenectomy may lead to some unfavorable consequences including increases of technical diffculty of surgery,operative duration,intraoperative bleeding,postoperative infection and other serious complications,and surgical mortality.Therefore,splenectomy should be performed cautiously for the patients who may receive liver transplantation in the future.
