Effect of liver transplantation on spleen size, collateral veins, and platelet counts

Fumio Chikamori, Seigo Nishida, Gennaro Selvaggi, Panagiotis Tryphonopoulos, Jang I. Moon, David M. Levi, Tomoaki Kato, Eddie R. Island, Akira Maki, Akin Tekin, Andreas G. Tzakis

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


Background: The aim of this study was to evaluate the effect of liver transplantation on the spleen size, spontaneous splenorenal shunt (SRS) function, and platelet counts in patients with hypersplenism. Methods: Between December 2001 and February 2007, 462 adult patients underwent orthotopic liver transplantations (OLTX) at our institution. Of these patients, CT or MRI information was reviewed retrospectively in 55 patients. Volume measurements of the spleen and liver, spleen/liver volume ratio (S/L ratio), presence and size of SRS, and platelet counts were evaluated before and after OLTX. Results: Mean spleen volume decreased from 827 ± 463 ml to 662 ± 376 ml after OLTX (p < 0.01). Five (11%) patients returned to normal-range spleen size after OLTX. SRS was observed in 19 patients before OLTX (35%). The diameter of SRS also significantly decreased from 1.0 ± 0.5 cm before OLTX to 0.7 ± 0.5 cm after OLTX (p < 0.05). SRS disappeared in 16% of patients (3/19). S/L ratio significantly decreased from 0.65 ± 0.33 to 0.38 ± 0.17 (p < 0.01) after OLTX. Platelet counts significantly increased after OLTX (p < 0.01). Improvement of the platelet count in the group with postoperative S/L ratio >0.35 was not as good as that in the group with S/L ratio <0.35 (p < 0.01). Conclusions: Spleen size and SRS size became significantly smaller after OLTX. However, patients with postoperative S/L ratio >0.35 tend to have lower platelet counts after OLTX.

Original languageEnglish
Pages (from-to)320-326
Number of pages7
JournalWorld Journal of Surgery
Issue number2
StatePublished - Feb 2010
Externally publishedYes


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