Splenic steal syndrome

Splenic steal syndrome is a possible complication after liver transplantation. In this syndrome, blood flows preferentially from the celiac artery into the splenic artery and the hepatic artery is relatively hypoperfused as a result. This complication can threaten a liver transplant's survival.

The incidence of splenic steal syndrome is uncertain since there are no clear imaging criteria. It has been estimated at somewhere between 0.6-10.1% of liver transplants 1.

Occurs in the early postoperative period and may present with elevated liver function tests.

Ultrasound

There are no specific ultrasound criteria for splenic steal syndrome at this time. Instead, Doppler ultrasound findings in the correct clinical setting may suggest the diagnosis and lead to follow up confirmatory angiography.

  • hypoperfusion in the main, left, and right hepatic arteries (manifested as low/absent diastolic flow and a high RI (>0.80)
  • no evidence of hepatic artery stenosis
  • increased velocity in the splenic artery (at least above 100-115 cm/s)
Angiography
  • injection of the celiac axis will show clearly preferential flow into the splenic artery and little contrast into the hepatic artery

Splenic steal syndrome can be treated with splenic embolisation.

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Article information

rID: 42515
Synonyms or Alternate Spellings:
  • Nonocclusive hepatic artery hypoperfusion syndrome

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