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Splenic artery aneurysm and orthotopic liver transplantation
A J Robertson1, M Rela, J Karani
1Liver Transplant Surgical Service, King's College Hospital, London, UK.
Insights
Splenic artery aneurysms are a rare but serious complication post-liver transplant. Early Doppler ultrasound screening in transplant candidates with cirrhosis can help detect these aneurysms for timely intervention.
Area of Science:
- Vascular Surgery
- Transplantation Surgery
- Hepatology
Background:
- Splenic artery aneurysms (SAAs) are uncommon vascular anomalies.
- SAAs can lead to severe hemorrhage, posing a significant risk.
- Liver transplantation is a complex procedure with potential complications.
Observation:
- Three adult cases of splenic artery aneurysms were identified within a 12-month period.
- These patients had undergone liver transplantation for chronic liver disease.
- The aneurysms presented as a complication post-transplantation.
Findings:
- Splenic artery aneurysms are a rare but potentially fatal complication following liver transplantation.
- Doppler ultrasound is a valuable tool for detecting SAAs in liver transplant candidates.
- Aneurysm ligation during the transplantation procedure is a feasible management strategy.
Implications:
- Routine splenic artery Doppler ultrasound screening should be considered for liver transplant candidates with cirrhosis and portal hypertension.
- Early detection and management of SAAs can improve patient outcomes and reduce transplant-related morbidity.
- Integrating SAA screening into pre-transplant protocols may prevent life-threatening complications.
Abstract:
Splenic artery aneurysms are a rare but potentially fatal complication after liver transplantation. We report three cases presenting in a 12-month period in adult patients who underwent transplantation for chronic liver disease. Doppler ultrasound of the splenic artery should be performed in all patients with cirrhosis and portal hypertension who are being assessed for liver transplantation. The aneurysm can be ligated at the time of transplantation.