SPLENIC ARTERY ANEURYSMS IN LIVER-TRANSPLANT PATIENTS

Background/Aims: The purpose of the study was to investigate the incid ence of and risk factors for splenic artery aneurysms in liver transpl ant patients. Methods: Medical records and the pre- and 1-year postope rative angiograms of 337 liver transplant patients were reviewed to as sess the presence and characteristics of these aneurysms. Results: For ty-five patients with aneurysms were identified (13%): 41 cases in 242 adult patients (17%) and four (4%) in 95 children (p<0.01). The femal e-to-male ratio was 2:1. The majority of the aneurysms (87%) were loca ted in the distal third of the splenic artery and the majority (87%) o f the patients presented multiple aneurysms, In patients without porta l hypertension no aneurysms were identified, whereas in 16% of the pat ients with portal hypertension aneurysms were found (p<0.001). In adul t patients the incidence of splenic artery aneurysms was significantly higher in patients with parenchymal diseases than in patients with ch olestatic diseases (p<0.0001). Two patients (4%) died due to rupture o f the aneurysms. Control angiographies, 1 year after liver transplanta tion, showed no changes in size and number of the aneurysms, and no ne w aneurysms were identified. Conclusions: The incidence of splenic art ery aneurysms in liver transplant patients is 13%, Their are generally multiple and located in the distal third of the splenic artery. The i ncidence is higher in women and in patients with parenchymal liver dis ease and portal hypertension, The incidence of rupture was 4%.