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Intervention on Spontaneous Splenorenal Shunt May Decrease the Incidence of Acute Kidney Injury After Liver
Arash Nickkholgh1, Jingzhou Wang, Rauf Shahbazov
1From the Department of Surgery, University of Virginia, Charlottesville, Virginia, USA; and the Department of Surgery, Ruprecht-Karls University, Heidelberg, Germany.
Summary
Intervening in spontaneous splenorenal shunts during liver transplants may reduce acute kidney injury. Most shunts persist post-transplant without intervention, suggesting intervention benefits transplant outcomes.
Area of Science:
- Hepatology
- Transplant Surgery
- Nephrology
Background:
- Spontaneous splenorenal shunt (SRS) is common in chronic portal hypertension.
- The impact of SRS intervention on liver transplant outcomes is debated.
Purpose of the Study:
- To compare outcomes of liver transplant recipients with and without SRS intervention.
- To evaluate the effect of SRS intervention on post-transplant complications and survival.
Main Methods:
- Retrospective comparison of 45 liver transplant recipients with large SRS (2012-2017).
- Intervention group (n=9) received various shunt obliteration or ligation procedures.
- Non-intervention group (n=36) served as controls.
Main Results:
- No significant differences in transfusion, hospital stay, thrombosis, thrombocytopenia, or survival between groups.
- Significantly lower post-transplant acute kidney injury in the intervention group (0% vs. 22%).
- SRS persisted in 85% of non-intervention patients at 1 year.
Conclusions:
- Peritransplant SRS intervention may decrease post-transplant acute kidney injury.
- SRS often persists post-liver transplant without intervention.
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