Chinese Journal of Tissue Engineering Research ›› 2012, Vol. 16 ›› Issue (5): 771-774.doi: 10.3969/j.issn.1673-8225.2012.05.003

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Liver transplantation for end-stage liver disease with hypersplenism 

Fang Ying-bing1, Jiang Yi1, Lü Li-zhi2, Cai Qiu-cheng2, Zhang Xiao-jin2   

  1. 1Clinical Medical College of Fuzhou General Hospital, Fujian Medical University, Fuzhou  350025, Fujian Province, China;
    2Department of Hepatobilliary Surgery, Fuzhou General Hospital of Nanjing Military Area Command, Fuzhou  350025, Fujian Province, China
  • Received:2011-07-07 Revised:2011-11-27 Online:2012-01-29 Published:2012-01-29
  • Contact: Jiang Yi, Professor, Doctoral supervisor, Clinical Medical College of Fuzhou General Hospital, Fujian Medical University, Fuzhou 350025, Fujian Province, China Jiangyi183@yahoo.com.cn
  • About author:Fang Ying-bing★, Studying for master’s degree, Clinical Medical College of Fuzhou General Hospital, Fujian Medical University, Fuzhou 350025, Fujian Province, China 952612193@qq.com
  • Supported by:

    Science and Technology Planning Project of Fujian Province, No.2011Y0046*

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Abstract:

BACKGROUND: Liver transplantation has become the most effective method to treat end-stage liver disease with hypersplenism. However, it is not certain that whether hypersplenism can occur when the speen is kept in the process of liver transplantation.
OBJECTIVE: To observe the recovery of spleen function after liver transplantation in end-stage liver disease with hypersplenism.
METHODS: Sixty-three cases of end-stage liver disease treated with liver transplantation were selected, and they were divided into two groups: hypersplenism group and non-hypersplenism group. Postoperative changes of the two groups in platelets, diameter from top to bottom measured by color ultrasound, intercostal thickness, splenic vein diameter at the portal vein were observed, and all the patients were followed-up for 15 months.
RESULTS AND CONCLUSION: Of the 63 cases selected, eight cases died, and 55 cases were analyzed. Only one case survived in the four cases which underwent parallel splenectomy. When surgery ended, platelets level in the hypersplenism group was significantly lower than that before surgery, and decreased to its lowest point at day 3 after surgery, then gradually increased,  obviously increased at day 7 (P < 0.05), and kept stable until month 15. Platelets level in the non-hypersplenism group dropped to its lowest point at day 5 after surgery, and reached the preoperative level at day 17. There were significant differences between the two groups (P < 0.05). In the hypersplenism group at day 7 after surgery, spleen diameter from top to bottom and thickness began to reduce significantly (P < 0.05); splenic vein diameter significantly reduced at month 3 (P < 0.05), and kept stable until month 15. In the 55 cases, no case was found portal hypertension and variceal bleeding. These findings suggest that the speen should be kept as far as possible in the process of liver transplantation if cases have no indications for splenectomy.

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