New strategies for prevention and treatment of splenic artery steal syndrome after liver transplantation

Figure 1 Doppler images during occluding the splenic artery. A: Normal portal vein and disappeared hepatic artery flow signal as revealed by Doppler ultrasonography on the 2^nd day after transplantation; B: Reappearance of the hepatic artery flow signal revealed by Doppler ultrasonography after the treatment by occluding the splenic artery temporarily; C: Better hepatic artery flow signal on the 5^th day after the treatment; D: Normal hepatic artery flow signal at the end of the 3^th month after the orthotopic liver transplantation.

Figure 2 Radiological images during occluding the splenic artery (arrow is the anastomotic site). A: Selective celiac trunk arteriogram shows reduced hepatic artery perfusion and enlarged splenic artery perfusion; B: Increased hepatic arterial perfusion was seen after occluding the splenic artery temporarily; C: Normal hepatic arterial flow was reestablished 5 d after the treatment.

Figure 3 Fluctuation of mean alanine transarninase in the recipients in the two groups after the treatments. The alanine transarninase (ALT) in the patients who underwent banding the splenic artery decreased faster than that in the patients in the control group. OLT: Orthotopic liver transplantation.

Figure 4 Fluctuation of alanine transarninase in the patients with splenic artery steal syndrome after the treatments. ALT: Alanine transarninase.