Hepatic artery thrombosis in pediatric liver transplantation

Hepatic artery thrombosis and liver malignancy in pediatric liver transplantation

“…In addition, there are a number of factors associated with an increased risk for HAT that were absent from our data set, including graft to recipient weight ratio, prolonged surgical time, hepatic artery size diameter, and cold ischemia time [8,10,20]. Still, many factors associated with HAT were recorded in this study, such as sex, type of graft, type of arterial anastomosis, use of perioperative FFP, and use of perioperative antithrombotic therapies [3,5,8,10,17]. These variables were so similar between our 2 groups that we chose to not include them as confounders in our relative risk regression.…”

“…The use of aspirin and alprostadil posttransplantation has proven effective at minimizing the incidence of HAT [17]. Similarly, the use of anticoagulants perioperatively and FFP intraoperatively have been associated with a decreased risk of HAT [3,5,18].…”

Arterial Anastomosis in Living Donor Liver Transplantation

“…The incidence of HAT has been reduced not only with the use of new and innovative surgical and microsurgical techniques (Aramaki et al, 2006) (Uchiyama et al, 2002), but also with posttransplantation administration of heparin, aspirin, alprostadil (PGE) (Heffron, et al, 2003), and/or gabexate mesilate (Miyagi et al, 2010 A proposed administration regime for heparin is 200 U/ kg of body weight per day for a period of 14 days. Administration of single dose of aspirin as low as 3 mg/kg will inactivate circulating platelets by acetylating the enzyme cyclooxigenase present in platelet wall and has a beneficial effect on anastomosis patency.…”

“…Some authors proved that anticoagulation utilizing ASA and alprostadil is sufficient to avoid HAT in pediatric recepients. (Heffron et al, 2003) Dextran can be administered as 500 mL over 5 to 6 hours once daily for 3 to 5 days or 500 mL slowly over a 24 hour period. The allergic reactions can be avoided by administration of dextran 1 instead of dextran 40.…”

Lebendspende-Lebertransplantation beim Kind

“…Eine Thrombose der A. hepatica findet sich in 4-6% der Fälle und erfordert meist die zügige Retransplantation. Als Risikofaktoren werden ein Gewicht <10 kg, ein Alter <3 Jahre sowie ein Gefäßdurchmesser <2 mm beschrieben [10]. Pfortaderthrombosen treten mit einer Inzidenz von 1-5% auf [11].…”