I may have missed it, but in addition to her pre-hepatic portal hypertension, what does the liver histology show or imaging ? Any ascites?
Her MELD score must be very low and you will not get exceptions.
We have cases of extreme splenomegaly even after liver transplant. We once considered spleen radiation even Y90, but there are no good results.
May be you can submit this case with films to Professor Riad Salem here at Northwestern.
Daniel R. Ganger, MD
Professor of Medicine and Surgery
Northwestern University
Chicago
Daniel R. Ganger, MD