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脾动脉盗血综合征:一个被忽视的肝病治疗靶点

刘全达 宋扬 周宁新

临床肝胆病杂志2011,Vol.27Issue(3):241-244,4.
临床肝胆病杂志2011,Vol.27Issue(3):241-244,4.

脾动脉盗血综合征:一个被忽视的肝病治疗靶点

Splenic arterial steal syndrome:a neglected therapeutic target for livel diseases

刘全达 1宋扬 2周宁新1

作者信息

  • 1. 第二炮兵,总医院肝胆胃肠病研究所,北京,100088
  • 2. 解放军总医院急诊科,北京,100853
  • 折叠

摘要

Abstract

The liver is extremely susceptible to ischemia resulting from arterial hypoperfusion, which is confirmed by the graft arterial complications(such as hepatic artery thrombosis, aneurysm) after liver transplantation.Arterial hypoperfusion may lead to severe complications, e.g.ischemic biliary destruction, graft loss, even recipient death.Splenic arterial steal syndrome(SASS) is a seldomrecognized arterial complication following liver transplantation.SASS describes the phenomenon of poor arterial perfusion of hepatic parenchyma due to “stealing” or diverting of blood from the hepatic artery to the dilated splenic artery.SASS also can cause severe graft morbidity if it is not managed timely.However, there still has no clear concept of SASS in cirrhosis, moreover, the clinicians have not realized its risks to liver dysfunction.Cirrhotic SASS is a consequence of chronic liver disease, and conversely aggravates the liver damage.The clinical manifestation of cirrhotic SASS is not special, and mostly accompanied with abnormalities of poor liver function caused by underlying liver diseases and splenomegaly.We have confirmed the prevalence of SASS in patients with decompensated cirrhosis by 3-dimensional CT angiography and celiac angiography, and also have demonstrated that the liver function, Child-Pugh score and classification of cirrhotic patients can be improved after correction of SASS, as well as reducing the risks of gastrointestinal bleeding.In conclusion, this article firstly proposed the concept of cirrhotic SASS, and confirmed that SASS is an efficacious therapeutic target for improvement of liver function in patients with decompensated cirrhosis, which can be a bridging therapy for patients awaiting liver transplantation.

关键词

肝硬化/肝移植/脾动脉盗血综合征

分类

医药卫生

引用本文复制引用

刘全达,宋扬,周宁新..脾动脉盗血综合征:一个被忽视的肝病治疗靶点[J].临床肝胆病杂志,2011,27(3):241-244,4.

基金项目

北京市首都临床特色应用研究重点项目(D101100050010042) (D101100050010042)

中国博士后科学基金(20080441275) (20080441275)

临床肝胆病杂志

OACSTPCD

1001-5256

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