vtioВестник трансплантологии и искусственных органовRussian Journal of Transplantology and Artificial Organs1995-1191Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation10.15825/1995-1191-2022-3-57-63vtio-1533Research ArticleКлиническая трансплантологияClinical TransplantologyРанняя диагностика и лечение синдрома обкрадывания селезеночной артерией после трансплантации печениEarly diagnosis and treatment of splenic artery steal syndrome after liver transplantationКиршинА. А.KirshinА. А.

Киршин Александр Александрович

Адрес: 420064, Казань, ул. Б. Урманче, 10-222Тел. (912) 467-52-79

Alexandr Kirshin

Address: 10-222, B. Urmanche str., Kazan, 420064Phone: (912) 467-52-79

kirshinalex80@mail.ruТерегуловA. Ю.TeregulovА. Yu.

Казань

Kazan

КиршинаА. Р.KirshinaA. R.

Казань

Kazan

ГАУЗ «Республиканская клиническая больница» Минздрава Республики Татарстан; Институт фундаментальной медицины и биологии Казанского федерального университетаРоссияRepublican Clinical Hospital; Kazan Federal UniversityRussian FederationГАУЗ «Республиканская клиническая больница» Минздрава Республики ТатарстанРоссияRepublican Clinical HospitalRussian Federation2022230820222435763Copyright © Киршин А.А., Терегулов A.Ю., Киршина А.Р., 20222022Киршин А.А., Терегулов A.Ю., Киршина А.Р.Kirshin А.А., Teregulov А.Y., Kirshina A.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.transpl.ru/vtio/article/view/1533

Цель исследования. Изучить частоту возникновения синдрома обкрадывания селезеночной артерией в собственной серии трансплантаций печени с определением диагностической и лечебной тактики. Материалы и методы. За 3,5 года существования программы трансплантации печени в Республике Татарстан выполнено 77 трансплантаций трупной печени. В послеоперационном периоде синдром обкрадывания селезеночной артерией встретился в 4 случаях (5,2%). Среди пациентов было 3 женщины и один мужчина, средний возраст составил 38 лет. Для диагностики применялись ультразвуковая доплерография сосудов печени и целиакография. В качестве способа коррекции синдрома использовалась проксимальная эмболизация селезеночной артерии. Результаты. Во всех клинических наблюдениях синдром обкрадывания селезеночной артерией был своевременно диагностирован и корректирован посредством рентгенэндоваскулярного вмешательства. Пациенты выписаны с хорошей функцией печеночного графта. Осложнение не повлияло на продолжительность госпитализации. Заключение. Синдром обкрадывания селезеночной артерией остается серьезным сосудистым осложнением трансплантации печени, способным привести к дисфункции и возможной потере графта. Его своевременное выявление и коррекция предотвращают тяжелые последствия для реципиента печени.

Objective: to study the incidence of splenic artery steal syndrome (SASS) in our own series of liver transplant surgeries and to determine diagnostic and therapeutic tactics. Materials and Methods. During the 3.5 years of existence of the liver transplant program in the Republic of Tatarstan, 77 cadaveric liver transplantations (LTx) have been performed. Postoperative SASS occurred in 4 cases (5.2%). Among the patients were 3 women and 1 man; mean age was 38 years. Doppler ultrasonography of the liver vessels and celiacography were used for diagnosis. Proximal splenic embolization was used as a way to correct the syndrome. Results. In all clinical cases, SASS was timely diagnosed and corrected by endovascular image-guided intervention. The patients were discharged with good hepatic graft function. The complication did not affect the length of hospital stay. Conclusion. SASS remains a severe vascular complication of LTx, which can lead to graft dysfunction and possible loss. Timely detection and treatment prevent severe consequences for the liver recipient.

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The authors declare that there are no conflicts of interest present.