University of Illinois Chicago, Metropolitan Group Hospitals, Department of Surgery, 836 W. Wellington Ave, Room 4807, Chicago, IL 60657, USA.
Einstein Medical Center, Department of Radiology, 5501 Old York Road, Philadelphia, PA 19141, USA.
Int J Surg. 2014 Nov;12(11):1228-34. doi: 10.1016/j.ijsu.2014.09.012. Epub 2014 Oct 12.
Splenic Artery Syndrome (SAS) has emerged as a controversial cause for graft ischemia in orthotopic liver transplant (OLTx) recipients. A complex combination of factors including hepatic artery hypoperfusion and portal hyperperfusion can result in SAS. Clinical and laboratory findings suggest graft ischemia but are generally non-specific. Conventional angiography findings of hepatic artery hypoperfusion with early and rapid filling of the splenic artery are suggestive of the diagnosis in the appropriate clinical setting. Treatment involves proximal splenic artery embolization, surgical splenic artery ligation, or in extreme cases, splenectomy. Most patients with SAS improve clinically following treatment. However, no randomized control trials are available to compare treatment options. Identification of at risk patients with pre-operative CT scans and intra-operative ultrasound has been proposed by some and may allow for prophylactic treatment of SAS.
脾动脉综合征（SAS）已成为原位肝移植（OLTx）受者移植肝缺血的一个有争议的原因。多种因素的复杂组合，包括肝动脉低灌注和门静脉高灌注，可导致 SAS。临床和实验室检查提示存在移植物缺血，但通常无特异性。在适当的临床环境中，肝动脉低灌注伴脾动脉早期快速充盈的常规血管造影表现有助于诊断。治疗包括脾动脉近端栓塞、脾动脉结扎术，或在极端情况下进行脾切除术。大多数 SAS 患者在治疗后临床状况改善。然而，目前尚无随机对照试验来比较治疗选择。一些人提出，术前 CT 扫描和术中超声检查可以识别高危患者，并可能允许预防性治疗 SAS。
