Hepatobiliary & pancreatic diseases international : HBPD INT · 2026
Proximal splenic artery ligation improves liver reperfusion, mitigates graft injury and decreases complications after liver transplantation.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Wu Zhao-Yi, Fu Neng-Sheng, Ji Yu-Jun, Tan Ying, Jiang Di, Zhang Yu-Jun, Zhang Lei-Da, Zhang Cheng-Cheng
Аннотация
BACKGROUND: Graft restoration after liver transplantation (LT) critically depends on adequate hepatic arterial blood flow. Splenic artery ligation (SAL) demonstrates flow-enhancing effects, though its safety and efficacy require evaluation.
METHODS: A total of 294 LT recipients were stratified into LT without proximal SAL (non-SAL group, n = 262) and LT with proximal SAL (SAL group, n = 32) groups. A 30-minute warm ischemia rat LT model was established, with rats randomized into the control and SAL groups. Biological samples were collected from the control and SAL groups on post-LT days 1, 3, and 7 (n = 5 per time point).
RESULTS: Splenic computed tomography scan showed 25% SAL recipients had splenic infarction volume > 20% in 1 month, with significantly reduced infarction in 6 months post-LT [post-LT 1 month splenic infarction volume 20%-50% group, 25.11% (1-month) vs. 0.017% (6-month), P < 0.001; post-LT 1 month splenic infarction volume > 50% group, 60.41% (1-month) vs. 24.38% (6-month), P = 0.018]. The SAL group demonstrated significantly smaller spleen size at both 1-month (785 cm3) and 6-month (651 cm3) versus pre-LT (1064 cm3, both P < 0.001) and decreased early allograft dysfunction (9.4% vs. 31.0%, P = 0.039) and non-anastomotic biliary stricture incidence (6.2% vs. 25.9%, P = 0.046) compared with the non-SAL group. Proximal SAL did not result in abscess formation or pancreatitis. Consistent with clinical observations, the rat SAL group developed splenic infarction without abscess formation. Ultrasound showed 1.21-fold higher hepatic arterial flow velocity in the SAL group (525 vs. 433 mm/s, P < 0.001), with unchanged portal vein flow (147 vs. 142 mm/s, P = 0.664). Laser speckle imaging showed 67% higher hepatic arterial flow in the SAL group (1535 vs. 915 PU, P < 0.001). The SAL group manifested significant graft restoration and continuous biliary tree structures; histopathological analysis showed milder epithelial damage, reduced inflammation and proinflammatory cytokines, and diminished ductular reaction (all P < 0.05 compared with the non-SAL group).
CONCLUSIONS: Proximal SAL improved hepatic artery blood supply, ameliorated graft injury and decreased complications in LT.
METHODS: A total of 294 LT recipients were stratified into LT without proximal SAL (non-SAL group, n = 262) and LT with proximal SAL (SAL group, n = 32) groups. A 30-minute warm ischemia rat LT model was established, with rats randomized into the control and SAL groups. Biological samples were collected from the control and SAL groups on post-LT days 1, 3, and 7 (n = 5 per time point).
RESULTS: Splenic computed tomography scan showed 25% SAL recipients had splenic infarction volume > 20% in 1 month, with significantly reduced infarction in 6 months post-LT [post-LT 1 month splenic infarction volume 20%-50% group, 25.11% (1-month) vs. 0.017% (6-month), P < 0.001; post-LT 1 month splenic infarction volume > 50% group, 60.41% (1-month) vs. 24.38% (6-month), P = 0.018]. The SAL group demonstrated significantly smaller spleen size at both 1-month (785 cm3) and 6-month (651 cm3) versus pre-LT (1064 cm3, both P < 0.001) and decreased early allograft dysfunction (9.4% vs. 31.0%, P = 0.039) and non-anastomotic biliary stricture incidence (6.2% vs. 25.9%, P = 0.046) compared with the non-SAL group. Proximal SAL did not result in abscess formation or pancreatitis. Consistent with clinical observations, the rat SAL group developed splenic infarction without abscess formation. Ultrasound showed 1.21-fold higher hepatic arterial flow velocity in the SAL group (525 vs. 433 mm/s, P < 0.001), with unchanged portal vein flow (147 vs. 142 mm/s, P = 0.664). Laser speckle imaging showed 67% higher hepatic arterial flow in the SAL group (1535 vs. 915 PU, P < 0.001). The SAL group manifested significant graft restoration and continuous biliary tree structures; histopathological analysis showed milder epithelial damage, reduced inflammation and proinflammatory cytokines, and diminished ductular reaction (all P < 0.05 compared with the non-SAL group).
CONCLUSIONS: Proximal SAL improved hepatic artery blood supply, ameliorated graft injury and decreased complications in LT.