Simultaneous partial splenectomy during liver transplantation for advanced cirrhosis patients combined with severe splenomegaly and hypersplenism

Table 1 Preoperative characteristics

	LT group (n = 43)	PSLT group (n = 41)	P value
Gender (male/female)	27/16	28/13	0.651
Age, yr	49.2 ± 12.8	52.7 ± 13.1	0.219
Indication for transplantation
Hepatitis B cirrhosis	19	21	0.662
Hepatic malignancy	10	8	0.792
Alcoholic cirrhosis	8	6	0.772
Autoimmune liver disease	2	3	0.672
etc.	4	3	> 0.99
MELD score at transplantation	19.4 ± 4.9	20.7 ± 4.6	0.214
PreOP biology
Total bilirubin (μmol/L)	133.0 ± 106.9	128.5 ± 97.2	0.841
Serum creatinine (μmol/L)	96.1 ± 72.6	82.6 ± 66.3	0.377
INR	1.6 ± 0.6	1.7 ± 0.6	0.447
Plasma ammonia (μmol/L)	59.7 ± 21.5	57.6 ± 23.4	0.669
PreOP platelet count, 103/mm3	38.6 ± 14.7	36.9 ± 14.1	0.590
PreOP spleen volume, cm3	1665 ± 611	1711 ± 682	0.745
PreOP PV flow, cm/s	12.4 ± 3.9	11.8 ± 3.7	0.472
PreOP HA flow, cm/s	40.3 ± 22.1	40.9 ± 21.7	0.453

LT: Liver transplantation; PSLT: Partial splenectomy during liver transplantation; HA: Hepatic artery; PV: Portal vein; MELD: Model for End-Stage Liver Disease; INR: International normalized ratio; PreOP: Preoperative.

Table 2 Donors’ characteristics

	LT group (n = 43)	PSLT group (n = 41)	P value
Gender (male/female)	31/12	28/13	> 0.99
Age, yr	42.6 ± 16.3	44.5 ± 15.9	0.665
Cause of death
Cerebral trauma	24	22	> 0.99
Cerebrovascular accident	10	8	0.792
Brain tumor (glioma)	4	5	0.735
Hypoxic brain injury	2	3	0.672
etc.	3	3	> 0.99
ICU stay, d	2.71 ± 2.05	2.83 ± 2.24	0.798

LT: Liver transplantation; PSLT: Partial splenectomy during liver transplantation; ICU: Intensive care unit.

Table 3 Operative characteristics

	LT group (n = 43)	PSLT group (n = 41)	P value
Operating time, h	6.8 ± 0.9	8.6 ± 1.3	< 0.001
Time for PS		1.8 ± 0.3
Blood loss, mL	349.4 ± 116.9	440.8 ± 141.3	0.002
During PS		85.6 ± 79.2
PostOP HA flow, cm/s	42.6 ± 11.4	49.3 ± 13.6	0.016
PostOP PV flow, cm/s	47.6 ± 14.1	42.7 ± 13.8	0.022
Weight of PS, g		787 ± 371.4
Percentage of PS, (n)
Half of spleen		23
Third of spleen		18

LT: Liver transplantation; PSLT: Partial splenectomy during liver transplantation; HA: Hepatic artery; PV: Portal vein; PreOP: Preoperative.

Table 4 Postoperative complications, n (%)

	LT group (n = 43)	PSLT group (n = 41)	P value
Postoperative hypersplenism	22 (51.1)	2 (4.8)	< 0.001
Recurrent ascites	8 (18.6)	1 (2.4)	0.029
Reoperation due to post-op bleeding	2 (4.6)	3 (7.3)	0.672
Postoperative pulmonary infection	5 (11.6)	4 (9.7)	> 0.99
Post-op thrombosis	1 (2.3)	1 (2.4)	> 0.99
Splenic arterial steal syndrome	4 (9.3)	0	0.116
Two-stage splenic embolization	17 (39.5)	0	< 0.001
Further splenectomy	6 (13.9)	0	0.026

LT: Liver transplantation; PSLT: Partial splenectomy during liver transplantation.