Background
Hepatocyte hypoxia may be a mechanism determining abnormal tissue oxygenation and
dysfunction of the cirrhotic liver. Since the introduction of radiofrequency ablation
(RFA) for patients with cirrhotic hypersplenism, we observed a phenomenon of visible
hepatic regeneration. This study aims to investigate the potential mechanism of RFA-induced
liver regeneration, and the 2-year outcomes of splenic RFA.
Methods
Forty patients who underwent splenic RFA for cirrhotic hypersplenism were followed
for 24 months. Before and after RFA procedures, portal hemodynamics and liver and
spleen volumes were measured by Doppler ultrasonography and computed tomography volumetry.
Liver function tests and blood counts were also determined.
Results
The splenic and portal venous flows decreased, but hepatic arterial flow (HAF) increased
dramatically after the RFA procedure. Liver volumes at 3 month post-RFA increased
compared to the baseline volumes (872 ± 107 vs. 821 ± 99 cm3, P = .031). A correlation was found between maximum absolute values of liver volumes
(▵liver volumes) and that of HAF (▵HAF) in Child-Pugh class A/B patients (r = 0.60;
P < .001). Leukocyte and platelet counts, as well as liver function, improved substantially
during the 2-year follow-up. Patients with ≥40% of spleen volume ablated had better
improvement of thrombocytopenia. No death or severe complications occurred.
Conclusions
RFA for cirrhotic hypersplenism is safe and efficacious. The increase in HAF as a
result of splenic RFA may improve liver function and induce liver regeneration in
cirrhotics, but further studies are necessary to clarify the underlying mechanisms.
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Article info
Publication history
Published online: January 31, 2008
Accepted:
November 15,
2007
Identification
Copyright
© 2008 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
