Liver Transplantation in Patients with Spontaneous Spleno-Renal Shunt
1Hepatobiliary Surgery and Liver Transplant Unit, Cruces University Hospital, Bilbao, Spain
2Clínica Universitaria Princesa Fabiola, Cordoba, Argentina.
Meeting: 2018 American Transplant Congress
Abstract number: A246
Keywords: Outcome, Portal veins, Surgical complications, Survival
Session Information
Session Name: Poster Session A: Liver Retransplantation and Other Complications
Session Type: Poster Session
Date: Saturday, June 2, 2018
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall 4EF
Aim: Our aim was to describe the outcomes of liver transplantation (LT) in patients with spontaneous spleno-renal shunt (SSRS) and to define the adequate portal flow.
Patients and methods: Recipients diagnosed of SSRS before LT between January 2005 and January 2017 were included in a retrospective study. Our policy was to achieve a final portal flow >80 mL/min/100 gr of liver weight or >1000 mL/min. The primary endpoint was patient survival.
Results: Sixty patients comprised the study group. Mean MELD score was 16 ± 6. Twenty patients had a portal thrombosis at the moment of LT and thrombendvenectomy was performed in 15. The technique for portal reconstruction was porto-portal termino-terminal in 56 cases, including 9 cases with left renal vein (LRV) ligation and one case with ligation of the shunt. Reno-portal reconstruction was performed in 4 cases. Overall, early primary dysfunction was observed in 12 patients (20%) including 3 patients with LRV ligation. Only 1 patient suffered a primary non-function (1.6%). Six patients died: de novo tumors 2, stroke 2, HCV recurrence 1 and infection 1. 1- and 5-year patient survival was 93.3% and 91%. Median portal flow in those patients who needed LVR ligation increased from 850 mL/min (266-1419) to 1732 mL/min (1063-3240) after ligation. This was comparable to the patients with porto-portal reconstruction and no need for LRV ligation (1782 mL/min (672-3780)). In 33 patients, graft weight was available. In these patients, median portal flow/100 gr of liver weight increased from 56 mL (34-79) to 111 mL (61-183) after LRV ligation, also comparable to the patients who did not need LRV ligation (118 mL (69-295)). Mean (SD) portal flow after reno-portal reconstruction was 1372 ± 798 mL/min.
Conclusión: A high patient survival was observed after LT in recipients with pretransplant SSRS when a final portal flow >80 mL/min/100 gr of liver weight or >1000 mL/min was achieved.
CITATION INFORMATION: Gastaca M., Bruno M., Ruiz P., Ventoso A., Palomares I., Prieto M., Valdivieso A. Liver Transplantation in Patients with Spontaneous Spleno-Renal Shunt Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Gastaca M, Bruno M, Ruiz P, Ventoso A, Palomares I, Prieto M, Valdivieso A. Liver Transplantation in Patients with Spontaneous Spleno-Renal Shunt [abstract]. https://atcmeetingabstracts.com/abstract/liver-transplantation-in-patients-with-spontaneous-spleno-renal-shunt/. Accessed May 15, 2025.« Back to 2018 American Transplant Congress