Liver Graft-To-Recipient Spleen Volume Ratio (GSVR) as A Preoperative Predictor of The Outcome Of Adult Living Donor Liver Transplantation (ALDLT). | ||
| The Egyptian Journal of Surgery | ||
| Volume 44, Issue 3, July 2025, Pages 1102-1111 PDF (601.63 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejsur.2025.359687.1388 | ||
| Authors | ||
| Amr Mostafa Aziz; Mohamed Balabel* ; Hazem Zakaria; Mahmoud Macshut | ||
| Department of Hepato-Pancreato-Biliary Surgery, National Liver Institute, Menoufia University, Menoufia Governorate, Egypt | ||
| Abstract | ||
| Background: The portal haemodynamic state is reflected in the spleen volume of cirrhotic recipients. Apart from pre-liver transplantation (LT) circumstances, increased portal venous flow following reperfusion during LT is also linked to the spleen volume; a low graft-to-spleen volume ratio (GSVR) has been found to predict postreperfusion portal hypertension (PHT). In order to prevent PHT, Gyoten et al. recently proposed that preoperative evaluation of GSVR may imply the necessity of splenectomy (SPX) before to reperfusion. Aim: The study aim is to validate the effect of splenectomy in recipients with low GSVR on the outcome of LDLT. Methods: This is a prospective cohort study. In our department of surgery at the National Liver Institute at Menoufia University, we operated on 77 cases between January 2021 and February 2024, 27 of which were paediatric cases that were not enrolled in the study and 50 of which were adult cases. Our study included 50 adult patients underwent ALDLT with or without splenectomy, 4 cases were excluded from study, 2 cases with GSVR >0.7 but splenectomy was done for previous hypersplenism, portal hypertension and other 2 cases with GSVR <0.7 but splenectomy wasn`t done because of weak intra-operative portal vein flow. Results: Our study revealed that there is significant correlation between the two groups regarding the platelet count and portal vein flow during the follow up of studied cases but there is no significant correlation regarding bilirubin level, PC/ INR or ascites amount. Conclusions: In our results, the difference is not significant between the 2 groups regarding postoperative complication or mortality. Increased Platelet count is the only significant parameter for splenectomy group. Further studies on Egyptian patients should be performed which can lead to different results and cut-off of GSVR due to the differences in the pathology of ESLD. | ||
| Keywords | ||
| GSVR; liver transplantation; portal hypertension; small for size syndrome | ||
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