A "blood theft" after liver transplantation: the role of interventional radiology in the management and treatment of splenic artery steal syndrome

Authors

  • Federica Riva Department of Radiology, Sant'Anna Hospital, Via Ravona, 22042 San Fermo della Battaglia, CO, Italy. https://orcid.org/0000-0002-4596-2882
  • Enrico Matteo Garanzini Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
  • Tommaso Cascella Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
  • Alfonso Vittorio Marchianò Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
  • Carlo Spreafico Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

DOI:

https://doi.org/10.3941/jrcr.v16i8.4391

Keywords:

Hepatocellular carcinoma, orthotopic liver transplant, angiography, splenic artery steal syndrome, embolization, ultrasound, interventional radiology, SAS, liver, spleen, CT, US

Abstract

Splenic artery steal syndrome is a rare complication after liver transplant. It could lead to rapidly evolving major issues such as ischemic cholangiopathy and acute graft failure. Although the pathophysiology is not yet well understood, if diagnosed in time it could be easily managed with interventional radiology treatments. We present a case of a 47-year-old man presented to our institute with radiological findings typical for multifocal hepatocellular carcinoma in a cirrhotic liver. After therapy he underwent transplant. Some days after surgery he developed signs of acute liver failure. Steal syndrome was suspected by laboratory tests and radiology exams. The syndrome was confirmed by angiography and treated. The graft was saved, and the patient is still alive and free of disease. The purpose of this paper is to explain the importance of radiology exams in the diagnosis of splenic steal syndrome, explain its pathogenesis and describe the interventional management of this complication.

Author Biographies

Federica Riva, Department of Radiology, Sant'Anna Hospital, Via Ravona, 22042 San Fermo della Battaglia, CO, Italy.

Department of Radiology

Enrico Matteo Garanzini, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

Department of Radiology and Radiotherapy

Tommaso Cascella, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

Department of Radiology and Radiotherapy

Alfonso Vittorio Marchianò, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

Department of Radiology and Radiotherapy

Carlo Spreafico, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

Department of Radiology and Radiotherapy, Head of Interventional radiology Unit
A "blood theft" after liver transplantation: the role of interventional radiology in the management and treatment of splenic artery steal syndrome by Federica Riva et al.

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Published

2022-08-31

Issue

Vol. 16 No. 8 (2022)

Section

Interventional Radiology

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