Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
권호 표지

Effect of Splenic Artery Interruption on Complete Blood Count Profiles in Living Donor Liver Transplant Recipients

비장동맥 차단술이 생체간이식 수술 수혜자의 전혈구 수치 변화에 미치는 영향

  • Kim, Wan-Joon (Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Moon, Deok-Bog (Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Jeong-Ik (Department of Surgery, Busan Paik Hospital, Inje University College of Medicine) ;
  • Hwang, Shin (Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Ki-Hun (Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ahn, Chul-Soo (Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ha, Tae-Yong (Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Song, Gi-Won (Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jung, Dong-Hwan (Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Kwan-Woo (Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choi, Nam-Kyu (Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Gil-Chun (Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Yu, Young-Dong (Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Pyung-Jae (Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choi, Young-Il (Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choi, Kun-Moo (Department of Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Lee, Sung-Gyu (Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • 김완준 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과학교실) ;
  • 문덕복 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과학교실) ;
  • 박정익 (인제대학교 의과대학 부산백병원 외과학교실) ;
  • 황신 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과학교실) ;
  • 김기훈 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과학교실) ;
  • 안철수 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과학교실) ;
  • 하태용 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과학교실) ;
  • 송기원 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과학교실) ;
  • 정동환 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과학교실) ;
  • 김관우 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과학교실) ;
  • 최남규 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과학교실) ;
  • 박길춘 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과학교실) ;
  • 유영동 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과학교실) ;
  • 박평재 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과학교실) ;
  • 최영일 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과학교실) ;
  • 최건무 (울산대학교 의과대학 강릉아산병원 외과학교실) ;
  • 이승규 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과학교실)
  • Published : 2009.12.31

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Abstract

Purpose: Splenectomy during living donor liver transplantation (LDLT) in a hepatitis C virus (HCV)-related cirrhotic recipient was performed by a Tokyo group to enhance the patient's tolerability to post-operative anti-viral treatment by improving complete blood count (CBC) profiles. At our institution, interruption of the splenic artery (SPA) by ligation or embolization in lieu of splenectomy, has been performed in LDLT to modulate portal blood flow in small-for-size graft LDLT or to prevent rupture of SPA aneurysms in recipients. We aimed to determine if interruption of the SPA can serve as an alternative management to splenectomy in LDLT recipients based on our data. Methods: Patients were classified into the splenic artery ligation group (SAL; n=26) and splenic artery embolization group (SAE; n=19), respectively. Among the recipients without SPA interruption, age-, gender-, and severity of cirrhosis-matched 25 recipients were selected as a control group. Post-operative CBC profiles and spleen size were reviewed retrospectively and compared between the groups. Results: After SAL, platelet and neutrophil counts were significantly increased at 3 and 6 months, and at 1 week and 1 month, respectively (p<0.05). After SAE, platelet and neutrophil counts were significantly increased at 3 and 6 months, and at 1 week and 3 months, respectively. There were no significant complications related to interruption of the SPA. Conclusion: Interruption of the SPA may have a role in improving neutrophil and platelet counts in LDLT recipients with severe pancytopenia or in whom antiviral treatment for HCV in anticipated.

Keywords

References

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