Interventional Radiology-Guided Splenic Artery Embolism in Liver Transplant Patients: A 10-Year Experience

Document Type

Conference Proceeding

Publication Date

6-1-2023

Publication Title

Am J Transplant

Abstract

Purpose: This study aims to evaluate the efficacy and safety of splenic artery embolism (SAE) for the management of portal hypertension in patients who have had liver transplants Methods: A retrospective analysis was conducted on liver transplant patients who had underwent interventional radiology (IR) guided SAE post-transplant at a single tertiary transplant center from 2012 to 2022. The primary outcome of intervention efficacy was quantified by peak hepatic artery resistive indices and main portal vein velocities. Ultrasound with doppler obtained before and after the intervention were reviewed for these parameters. The average changes were calculated at a 95% confidence interval. Adverse events were also recorded at the time of the procedure and within one year of the procedure. Secondary outcomes that were measured included platelet count before and 1 month after procedure, spleen size, and need for subsequent splenectomy. Results: All 28 of the patients were white and 18 were males. The mean age of patient was 52.5 years (21-71 years) and time after transplant was 149.5 Days (2-1588 days). 96.4% of SAE were technically successful (n=27). 21 patients had main portal vein (MPV) velocities available and 24 had peak hepatic artery resistive indices (RI) available. In these patients, hepatic artery RI decreased by an average of 0.063 (95% CI 0.014-0.112) after SAE. MPV velocity decreased by an average of 47.2 cm/s (95% CI 27.3-67.1) after SAE. Absolute platelet count increased by an average of 60.0 K/uL (95% CI 36.7-83.3) with a 115.6% increase (95% CI 64.9- 166.3). 10.4% of patients (n=3) developed a procedure-related complication, all of which were femoral access site aneurysms. 0% of patients (n=0) patients suffered from bleeding, infections, or abscesses after the procedure. 10.7% of patients (n=3) required splenectomy after SAE. 1 splenectomy was due to technical failure and 2 were due to refractory symptoms. The change in spleen size was available in 26 patients and the average decrease is size was 1.07 cm (0.78-1.36) or 7% (5-9%) at a 95% confidence interval. Conclusions: IR-guided splenic artery embolism in liver transplant patients is a safe and effective procedure that carries an acceptable complication risk. Patients saw an improvement in both the hepatic artery resistive indices and main portal vein velocity post-embolization. CITATION INFORMATION: Obri M., Kamran W., Almajed M., Obri M. Interventional Radiology-Guided Splenic Artery Embolism in Liver Transplant Patients: A 10-Year Experience AJT, Volume 23, Issue 6, Supplement 1. DISCLOSURES: M.S.Obri: None. W.Kamran: n/a. M.Almajed: n/a. M.Obri: n/a.

Volume

23

Issue

6

First Page

S1187

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