Late hepatic artery thrombosis after liver transplantation: clinical setting and risk factors

Leonardi, M.I.; Boin, I.F.S.F.; Leonardi, Luiz Sérgio

doi:10.1016/j.transproceed.2004.03.121

Cited by 25 publications

(20 citation statements)

References 13 publications

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“…11 The local adverse factors are the availabil-ity of only one HA which is short in length and diameter, anatomical variations of the right/left lobe in the donor, impaired quality and size difference of the allograft vessels and deep location of the vessels. 3,4 To manage most of these challenges and to increase the success rate, some surgeons advocate the use of microsurgical techniques [12][13][14][15] while others do not.…”

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confidence: 99%

Collaboration with microsurgery prevents arterial complications and provides superior success in partial liver transplantation

et al. 2006

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Hepatic artery thrombosis is the most common technical complication in liver transplantation. The objective of this study was to investigate the arterial complications of partial liver transplantation using microsurgical technique. At a period of 31-months, we participated in a total of 42 right lobes, 7 left lobes, and 1 whole-liver liver transplantations from cadaveric (n = 20) or living (n = 30) donors. Hepatic artery anastomosis was performed using microsurgical techniques. All anastomoses were accomplished successfully. Fifteen patients expired postoperatively and 35 hepatic artery anastomoses remained patent at a mean follow-up period of 10.6 +/- 8.4 months. The mean diameters of the donor and recipient hepatic arteries were 2.9 +/- 1.2 mm and 3.2 +/- 1.1 mm, respectively. Specific technical challenges were encountered during operation in eight cases (16%). We have found that microsurgical techniques are not only useful for a superior anastomosis but also reliable to adapt to vascular anomalies with less arterial complications. complications.

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confidence: 99%

Collaboration with microsurgery prevents arterial complications and provides superior success in partial liver transplantation

et al. 2006

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“…Although collateral transformation of the hepatic artery after liver transplantation is not often observed, it is frequently seen in patients with late (>1 month) hepatic artery complications. [1][2][3] In this study, all 15 patients with hepatic artery collaterals had late hepatic artery compli- cations that were hepatic artery thrombosis or stenosis. Thus, hepatic artery collaterals may be highly specific signs of hepatic artery thrombosis or stenosis.…”

Section: Discussionmentioning

confidence: 78%

“…The clinical symptoms of patients with hepatic artery collaterals are often nonspecific and vary from elevated liver enzyme levels to eventual hepatic necrosis and sepsis 1 – 3 , 10 , 11 . Color Doppler flow imaging is the preferred imaging method for examining vascular complications after liver transplantation; however, this method has many shortcomings.…”

Section: Discussionmentioning

confidence: 99%

“…Collateral transformation of the hepatic artery often occurs in patients with late hepatic artery thrombosis after liver transplantation 1 – 3 . In these cases, survival of the allograft depends on the patency of the collateral arteries.…”

mentioning

confidence: 99%

“…In these cases, survival of the allograft depends on the patency of the collateral arteries. A few of them have a stable clinical course, but most have liver abscesses and bile duct complications 1 – 3 . For these reasons, patients with collateral transformation of the hepatic artery merit close clinical follow‐up and routine sonographic examinations.…”

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confidence: 99%

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Contrast‐Enhanced Sonography for Diagnosing Collateral Transformation of the Hepatic Artery After Liver Transplantation

Lyu

Ren

Zheng

et al. 2015

J of Ultrasound Medicine

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Collateral transformation of the hepatic artery in patients with hepatic artery complications after liver transplantation appears to have characteristic features on contrast-enhanced sonography, especially a reticulated or patchy enhancement pattern in the porta hepatis region during the arterial and early portal phases combined with the absence of the peripheral hepatic artery. Contrast-enhanced sonography may be a novel method for diagnosing hepatic artery collateral transformation, which may be a highly specific sign of hepatic artery thrombosis or stenosis.

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Intercurrent infection predicts mortality in patients with late hepatic artery thrombosis listed for liver retransplantation

et al. 2012

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Liver retransplantation for late hepatic artery thrombosis (HAT) is considered the treatment of choice for select patients. Nevertheless, there is a paucity of data to aid decision making in this setting. The aims of this single-center study of patients listed for late HAT were (1) to determine variables associated with wait-list mortality, (2) to describe survival after retransplantation, and (3) to determine variables associated with mortality after retransplantation. Seventy-eight patients were diagnosed with late HAT (incidence ¼ 3.9%). Of the 49 patients listed for retransplantation, 9 died on the waiting list and 36 were retransplanted. The estimated 1-year survival after listing for retransplantation was 53.7%. Only multidrug-resistant (MDR) bacteria-positive cultures were predictive of wait-list mortality (P ¼ 0.01). After retransplantation, the estimated 1-and 5-year patient survival was 71.9% and 62.5%, respectively. Increasing Model for End-Stage Liver Disease score (overall P ¼ 0.007), MDR bacteria-positive cultures (P ¼ 0.047), and continued antibiotic therapy (P ¼ 0.001) at the time of retransplantation were risk factors for post retransplant death. In conclusion, patients who undergo liver retransplantation for late HAT have satisfactory outcomes. However, the presence of active infection and MDR bacteria-positive cultures should be taken into account when risk stratifying such patients.

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Late hepatic artery thrombosis after liver transplantation: clinical setting and risk factors

Cited by 25 publications

References 13 publications

Collaboration with microsurgery prevents arterial complications and provides superior success in partial liver transplantation

Collaboration with microsurgery prevents arterial complications and provides superior success in partial liver transplantation

Contrast‐Enhanced Sonography for Diagnosing Collateral Transformation of the Hepatic Artery After Liver Transplantation

Intercurrent infection predicts mortality in patients with late hepatic artery thrombosis listed for liver retransplantation

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