Management of early hepatic artery occlusion after liver transplantation with failed rescue
Journal
World Journal of Gastroenterology
Journal Volume
21
Journal Issue
44
Pages
12729-12734
Date Issued
2015
Abstract
Hepatic artery thrombosis is a serious complication after liver transplantation which often results in biliary complications, early graft loss, and patient death. It is generally thought that early hepatic artery thrombosis without urgent re-vascularization or retransplantation almost always leads to mortality, especially if the hepatic artery thrombosis occurs within a few days after transplantation. This series presents 3 cases of early hepatic artery thrombosis after living donor liver transplantation, in which surgical or endovascular attempts at arterial re-vascularization failed. Unexpectedly, these 3 patients survived with acceptable graft function after 32 mo, 11 mo, and 4 mo follow-up, respectively. The literatures on factors affecting this devastating complication were reviewed from an anatomical perspective. The collective evidence from survivors indicated that modified nonsurgical management after liver transplantation with failed revascularization may be sufficient to prevent mortality from early hepatic artery occlusion. Re-transplantation may be reserved for selected patients with unrecovered graft function. ? The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
SDGs
Other Subjects
acetylsalicylic acid; alanine aminotransferase; antibiotic agent; bilirubin; liver enzyme; urokinase; adolescent; adult; alcohol liver cirrhosis; anastomosis; artery catheter; artery dissection; Article; biliary tract infection; blood clot lysis; blood flow; cancer recurrence; cancer surgery; case report; computer assisted tomography; Doppler echography; endovascular surgery; female; follow up; hepatic artery; hepatic artery thrombosis; hepatitis C; hepatojejunostomy; human; hyperbilirubinemia; hypertransaminasemia; laparotomy; liver cell carcinoma; liver cirrhosis; liver function; liver parenchyma; liver transplantation; living donor; magnetic resonance angiography; male; microcatheter; middle aged; postoperative complication; primary sclerosing cholangitis; revascularization; surgical microscope; surgical mortality; survival; vascularization; adverse effects; Arterial Occlusive Diseases; diagnostic imaging; fibrinolytic therapy; liver transplantation; procedures; reoperation; stenosis, occlusion and obstruction; thrombosis; treatment failure; Adolescent; Arterial Occlusive Diseases; Constriction, Pathologic; Female; Hepatic Artery; Humans; Liver Transplantation; Living Donors; Male; Middle Aged; Reoperation; Thrombolytic Therapy; Thrombosis; Treatment Failure
Publisher
WJG Press
Type
journal article