Role of splenectomy in living-donor liver transplantation for adults.

Background/aims: Splenectomy is occasionally required in liver transplantation. However, its indications and drawbacks have not been clearly defined in living-donor liver transplantation.
Methodology: Eleven of 59 adult living-donor liver transplantation recipients underwent splenectomy. Indications were thrombocytopenia in 6 cases, portal flow disturbances due to splenorenal shunt in four, and splenic infarction in one. The incidence of bacterial complications and changes in platelet counts and portal vein flow were evaluated.
Results: Two patients died of pneumonia and cerebral bleeding, respectively. Six events of bacterial infections occurred in the remaining nine patients. After splenectomy, a normal portal flow was achieved and the platelet count significantly increased.
Conclusions: Splenectomy may be an acceptable option in patients with thrombocytopenia or when it is necessary to change the portal flow.