Resident | Clinician Scientist Charité - Universitätsmedizin Berlin | Berlin Institute of Health Berlin Institute of Health, Germany
Purpose: This study compared proximal and distal embolization of the splenic artery (SA) in patients with splenic artery steal syndrome (SASS) after orthotopic liver transplantation (OLT) regarding changes of liver function after treatment in order to find an ideal location of embolization.
Material and Methods: 80 patients with SASS after OLT treated with embolization of the SA between 2007 and 2017 were retrospectively reviewed. Periinterventional DSA was used to assess treatment success and to stratify patients according to the site of embolization. Liver function was assessed using: Bilirubin (TBIL), Albumin, Gamma-glutamyltransferase (GGT), Alanine-transaminase (ALT), Aspartate-transaminase (AST), INR and thrombocytes. Descriptive statistics were used to summarize the data. Mean lab values of pre, 1- and 3-days, as well as 1-week and 1-month post-embolization were compared using uni- and multivariate linear regressions models.
Results: All procedures were technically successful and showed an improved blood flow in the hepatic artery post-embolization. 5 Patients were excluded due to missing lab values or inconsistent image documentation. TBIL (6,5 vs. 9,8 mg/dl), ALT (103,40 vs. 321,06 U/l) and AST (62,65 vs. 259,28 U/l, all values post-3-days respectively) showed a trend towards separation within the first 3-days post-embolization, showing a lower liver funtion in the distal treatment group. However, 1-month post-embolization values matched again, with no significant separation. No statistical significant (p<.05) differences could be detected in the mixed linear regression model for any of the reviewed liver outcome parameter.
Conclusions: We conclude, that the site of embolization of the SA might solely be chosen by the technical practicability of the procedure.