Application of image post-processing technique to measure spleen volume and evaluate the effect of orthotopic liver transplantation on relieving hypersplenism

Abstract

Objective To employ image post-processing technique measuring splenic volume for evaluating the mitigation effect of end-stage liver disease patients complicated with different degrees of hypersplenism undergoing orthotopic liver transplantation. Methods For 55 end-stage liver disease patients with hypersplenism undergoing orthotopic liver transplantation, the changes in splenic volume were measured before and after transplantation by image post-processing system Advantage Workstation 46 (AW46) and the changes of splenic thickness, portal flow velocity and platelet counts observed during perioperative period. Results Postoperative splenic volumes of 55 recipients were (562.90±49.16) cm3, significantly decreased than preoperative (850.50±77.99) cm3 (P<0.05) and reduction ratio was (31.70±2.76)%. Splenic thickness at different postoperative timepoints was significantly lower than that pre-operation (P<0.05) and stabilized at 1 month post-transplantation; Splenic volume was positively correlated with splenic thickness (r=0.78, P<0.05). Portal flow velocity at different postoperative timepoints increased significantly as compared with preoperative (P<0.05), peaked at (380.70±21.80) mm/s at 1 month post-transplantation, declined and stabilized at 3 months post-transplantation. Platelet counts (PLT) at different postoperative timepoints were significantly higher than those at pre-operation (P<0.05), peaked (193.40±10.36)×109/L at 2 weeks post-transplantation, dropped and remained at 2 months post-transplantation; Splenic volume was negatively correlated with PLT (r=-0.44, P<0.05). And hypersplenism recovery rate and recurrence rate within 10 months post-transplantation was (78.79±2.29)% and (17.75±2.31)% respectively. Conclusions Orthotopic liver transplantation can effectively alleviate hypersplenism for most end-stage liver diseases. Using image post-processing system, splenic volume may be calculated and blood routine and ultrasound are simultaneously used for assessing the outcomes of liver transplantation on hypersplenism. Key words: Hypersplenism; Liver transplantation; Spleen volume; Platelet