Simultaneous splenectomy during liver transplantation augments anti-viral therapy in patients infected with hepatitis C virus
Simultaneous splenectomy during liver transplantation augments anti-viral therapy in patients infected with hepatitis C virus
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DOI：
10.1016/j.amjsurg.2014.03.004
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发表时间：
2015-01-01
影响因子：
3
通讯作者：
Chen, Teng-Wei
中科院分区：
文献类型：
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作者：
Chu, Heng-Cheng;Hsieh, Chung-Bao;Chen, Teng-Wei
背景技术背景：由于脾门静脉血栓形成和败血症增加，肝移植（LT）中的同时脾切除术是有选择性的。因此，其影响应进一步调查。方法：在160例肝移植患者中，只有40例同时进行脾切除术。采用回顾性分析方法，比较脾切除组与非脾切除组的临床病理特征及预后。结果：两组患者的术中、术后资料相似，但非脾切除组男性患者较多。而脾切除组在移植后1个月和6个月时血小板和白细胞计数明显高于脾切除组，且丙型肝炎病毒抗病毒治疗完成率也高于脾切除组。此外，3例患者在术后随访期间发生门静脉或脾静脉血栓形成，但这些组之间的总生存率没有显著差异。结论：LT中的同时脾切除术可以安全地进行，特别是在丙型肝炎病毒肝硬化，小尺寸移植物，脾功能亢进和ABO血型不相容（ABO -不相容）LT的患者中。All rights reserved.
BACKGROUND: Simultaneous splenectomy in liver transplantation (LT) is selectively indicated because of splenoportal venous thromboses and increased sepsis. Therefore, its impact should be further investigated.METHODS: Of the 160 liver transplant patients, only 40 underwent simultaneous splenectomy. Clinicopathologic characteristics and outcomes were compared between the splenectomy and nonsplenectomy group using retrospective analysis.RESULTS: Although the groups were similar and had no significant difference in the intra-and postoperative data, non-splenectomy group had more male patients. However, splenectomy group showed significantly higher platelet and leukocyte counts at 1 month and 6 months after the transplantation and higher hepatitis C virus anti-viral therapy completion. Furthermore, 3 patients developed portal or splenic vein thrombosis during the postoperative follow-up, but the overall survival rate did not significantly differ between these groups.CONCLUSION: Simultaneous splenectomy in LT can be safely performed, particularly in patients with hepatitis C virus cirrhosis, small-for-size grafts, hypersplenism, and ABO blood group incompatible (ABO - incompatible) LT. (C) 2015 Elsevier Inc. All rights reserved.