{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T21:38:03Z","timestamp":1764020283759,"version":"3.40.5"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2019,4,19]],"date-time":"2019-04-19T00:00:00Z","timestamp":1555632000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,4,19]],"date-time":"2019-04-19T00:00:00Z","timestamp":1555632000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:p>Splenic artery (SA) ligation can be performed during liver transplantation (LT) to avoid portal hyperperfusion, which is involved in the pathogenesis of both small\u2010for\u2010size and SA syndrome. The SA can also be used as an inflow for arterial reconstruction. Exceptionally, SA interruption or agenesis has been associated with positive remodeling of collateral arteries supplying the spleen via the left gastric artery (LGA), short gastric vessels, and the gastroepiploic arcade (GEA), with subsequent severe upper gastrointestinal (GI) bleeding. To determine incidence, magnitude, predictors, and clinical implications of vascular remodeling after SA interruption during LT, we identified 465 patients transplanted in the period 2007\u20102017 who had the SA ligated or interrupted at LT. Among them, 88 had a computed tomography angiography suitable for evaluation of vascular remodeling after LT. The presence of prominent gastric arterial collaterals and the increase in LGA and GEA diameter were evaluated on 2\u2010dimensional axial images and multiplanar reconstructions. Of the 88 patients, 28 (31.8%), 32 (36.4%), and 22 (25.0%) developed gastric collateralization graded as mild, moderate, or severe. Of the patients for whom comparison with pre\u2010LT imaging was possible (n\u00a0=\u00a054), 51 (94.4%) presented a median 37% and 55% increase in LGA and GEA diameter, respectively. Severe gastric collateralization was associated with lower body mass index (odds ratio, 0.84; 95% confidence interval [CI], 0.71\u20100.98; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.03), whereas a GEA caliper measurement increase was positively correlated with Model for End\u2010Stage Liver Disease score (<jats:italic toggle=\"yes\">r<\/jats:italic>\n                           <jats:sup>2<\/jats:sup> = 0.12; 95% CI, 0.65\u20104.15; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.008). Out of 465 patients, 2 (0.43%) had severe episodes of arterial upper GI bleeding, possibly exacerbated by vascular remodeling. In conclusion, vascular remodeling after SA interruption during LT is frequent and can aggravate GI bleeding during follow\u2010up.<\/jats:p>","DOI":"10.1002\/lt.25447","type":"journal-article","created":{"date-parts":[[2019,3,18]],"date-time":"2019-03-18T18:43:43Z","timestamp":1552934623000},"page":"934-945","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Vascular Remodeling of Visceral Arteries Following Interruption of the Splenic Artery During Liver Transplantation"],"prefix":"10.1097","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4096-4504","authenticated-orcid":false,"given":"Damiano","family":"Patrono","sequence":"first","affiliation":[{"name":"Liver Transplant Center,General Surgery 2U, University of Torino, A.O.U. Citt\u00e0 Della Salute e Della Scienza,Torino,Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eloisa","family":"Franchi","sequence":"additional","affiliation":[{"name":"Liver Transplant Center,General Surgery 2U, University of Torino, A.O.U. Citt\u00e0 Della Salute e Della Scienza,Torino,Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Guarasci","sequence":"additional","affiliation":[{"name":"Radiology Department,University of Torino, A.O.U. Citt\u00e0 Della Salute e Della Scienza,Torino,Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Germana","family":"Bartoli","sequence":"additional","affiliation":[{"name":"Radiology Department,University of Torino, A.O.U. Citt\u00e0 Della Salute e Della Scienza,Torino,Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabetta","family":"Nada","sequence":"additional","affiliation":[{"name":"Liver Transplant Center,General Surgery 2U, University of Torino, A.O.U. Citt\u00e0 Della Salute e Della Scienza,Torino,Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Rigo","sequence":"additional","affiliation":[{"name":"Liver Transplant Center,General Surgery 2U, University of Torino, A.O.U. Citt\u00e0 Della Salute e Della Scienza,Torino,Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Ottobrelli","sequence":"additional","affiliation":[{"name":"Gastrohepatology Unit,A.O.U. Citt\u00e0 Della Salute e Della Scienza,Torino,Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Fonio","sequence":"additional","affiliation":[{"name":"Radiology Department,University of Torino, A.O.U. Citt\u00e0 Della Salute e Della Scienza,Torino,Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Salizzoni","sequence":"additional","affiliation":[{"name":"Liver Transplant Center,General Surgery 2U, University of Torino, A.O.U. Citt\u00e0 Della Salute e Della Scienza,Torino,Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8340-8885","authenticated-orcid":false,"given":"Renato","family":"Romagnoli","sequence":"additional","affiliation":[{"name":"Liver Transplant Center,General Surgery 2U, University of Torino, A.O.U. Citt\u00e0 Della Salute e Della Scienza,Torino,Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2019,4,19]]},"reference":[{"key":"lt25447-bib-0001-20240115","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1097\/01.SLA.0000055277.78876.B7","article-title":"Modulation of portal graft inflow: a necessity in adult living\u2010donor liver transplantation?","volume":"237","year":"2003","journal-title":"Ann Surg"},{"key":"lt25447-bib-0002-20240115","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1002\/lt.23763","article-title":"Hemodynamic changes in the hepatic circulation after the modulation of the splenic circulation in an in vivo human experimental model","volume":"20","year":"2014","journal-title":"Liver Transpl"},{"key":"lt25447-bib-0003-20240115","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1002\/lt.20762","article-title":"Effects of splenic artery occlusion on portal pressure in patients with cirrhosis and portal hypertension","volume":"12","year":"2006","journal-title":"Liver Transpl"},{"key":"lt25447-bib-0004-20240115","doi-asserted-by":"crossref","first-page":"1850","DOI":"10.1111\/j.1600-6143.2010.03207.x","article-title":"Prospective evaluation of intraoperative hemodynamics in liver transplantation with whole, partial and DCD grafts","volume":"10","year":"2010","journal-title":"Am J Transplant"},{"key":"lt25447-bib-0005-20240115","doi-asserted-by":"crossref","first-page":"S36","DOI":"10.1053\/jlts.2003.50200","article-title":"Clinical relevance of adapting portal vein flow in living donor liver transplantation in adult patients","volume":"9","year":"2003","journal-title":"Liver Transpl"},{"key":"lt25447-bib-0006-20240115","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/0002-9610(94)90210-0","article-title":"The recipient splenic artery for arterialization in orthotopic liver transplantation","volume":"167","year":"1994","journal-title":"Am J Surg"},{"key":"lt25447-bib-0007-20240115","first-page":"1263","article-title":"Recipient splenic artery utilization for arterial re\u2010anastomosis in living donor liver transplantation: single\u2010center experience","volume":"59","year":"2012","journal-title":"Hepatogastroenterology"},{"key":"lt25447-bib-0008-20240115","doi-asserted-by":"crossref","first-page":"1786","DOI":"10.1016\/j.transproceed.2007.10.012","article-title":"Splenic abscess after splenic artery ligation in living donor liver transplantation: a case report","volume":"40","year":"2008","journal-title":"Transplant Proc"},{"key":"lt25447-bib-0009-20240115","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1097\/00004728-199005000-00007","article-title":"Splenic infarction complicating pediatric liver transplantation: incidence and CT appearance","volume":"14","year":"1990","journal-title":"J Comput Assist Tomogr"},{"key":"lt25447-bib-0010-20240115","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1148\/radiographics.22.4.g02jl13881","article-title":"Collateral pathways in patients with celiac axis stenosis: angiographic\u2010spiral CT correlation","volume":"22","year":"2002","journal-title":"Radiographics"},{"key":"lt25447-bib-0011-20240115","doi-asserted-by":"crossref","first-page":"3003","DOI":"10.1111\/j.1572-0241.2000.03228.x","article-title":"Upper gastrointestinal bleeding from gastric submucosal arterial collaterals secondary to splenic artery occlusion: treatment by splenectomy and partial gastric devascularization","volume":"95","year":"2000","journal-title":"Am J Gastroenterol"},{"key":"lt25447-bib-0012-20240115","first-page":"456","article-title":"Congenital absence of the splenic artery associated with major gastric bleeding in adolescence","volume":"72","year":"1985","journal-title":"Br J Surg"},{"key":"lt25447-bib-0013-20240115","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1016\/j.gie.2007.09.044","article-title":"Splenic artery collaterals masquerading as gastric fundal varices on endoscopy: a sticky situation","volume":"67","year":"2008","journal-title":"Gastrointest Endosc"},{"key":"lt25447-bib-0014-20240115","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1002\/lt.23674","article-title":"Recurrent upper gastrointestinal bleeding masquerading as gastric variceal bleeding on endoscopy after liver transplantation","volume":"19","year":"2013","journal-title":"Liver Transpl"},{"key":"lt25447-bib-0015-20240115","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1111\/j.1600-6143.2006.01242.x","article-title":"Characteristics associated with liver graft failure: the concept of a donor risk index","volume":"6","year":"2006","journal-title":"Am J Transplant"},{"key":"lt25447-bib-0016-20240115","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1111\/j.1600-6143.2008.02491.x","article-title":"D\u2010MELD, a simple predictor of post liver transplant mortality for optimization of donor\/recipient matching","volume":"9","year":"2009","journal-title":"Am J Transplant"},{"key":"lt25447-bib-0017-20240115","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1056\/NEJMoa0801209","article-title":"Hyponatremia and mortality among patients on the liver\u2010transplant waiting list","volume":"359","year":"2008","journal-title":"N Engl J Med"},{"key":"lt25447-bib-0018-20240115","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.ejrad.2009.03.002","article-title":"Comprehensive ultrasound assessment of complications post\u2010liver transplantation","volume":"74","year":"2010","journal-title":"Eur J 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Anat"},{"key":"lt25447-bib-0022-20240115","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1038\/nrcardio.2013.207","article-title":"The dynamics of the coronary collateral circulation","volume":"11","year":"2014","journal-title":"Nat Rev Cardiol"},{"key":"lt25447-bib-0023-20240115","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1177\/112067211002000603","article-title":"Ocular neovascularization following central retinal artery occlusion: prevalence and timing of onset","volume":"20","year":"2010","journal-title":"Eur J Ophthalmol"},{"key":"lt25447-bib-0024-20240115","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1549-8719.2010.00008.x","article-title":"Marvels, mysteries, and misconceptions of vascular compensation to peripheral artery 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Transpl"},{"key":"lt25447-bib-0028-20240115","doi-asserted-by":"crossref","first-page":"e11","DOI":"10.1016\/j.jcf.2017.03.006","article-title":"Liver disease in cystic fibrosis presents as non\u2010cirrhotic portal hypertension","volume":"16","year":"2017","journal-title":"J Cyst Fibros"},{"journal-title":"Clin Gastroenterol Hepatol","article-title":"Obliterative portal venopathy without cirrhosis is prevalent in pediatric cystic fibrosis liver disease with portal hypertension","year":"2018","key":"lt25447-bib-0029-20240115"},{"key":"lt25447-bib-0030-20240115","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1038\/74651","article-title":"Mechanisms of angiogenesis and arteriogenesis","volume":"6","year":"2000","journal-title":"Nat Med"}],"container-title":["Liver Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lt.25447","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lt.25447","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01445473-201906000-00017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T01:26:22Z","timestamp":1705281982000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01445473-201906000-00017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4,19]]},"references-count":30,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1002\/lt.25447","relation":{},"ISSN":["1527-6465","1527-6473"],"issn-type":[{"type":"print","value":"1527-6465"},{"type":"electronic","value":"1527-6473"}],"subject":[],"published":{"date-parts":[[2019,4,19]]}}}