Selective Revascularization of Hepatic Artery Thromboses After Liver Transplantation Improves Patient and Graft Survival1

Pa, Sheiner; Cv, Varma; Jv, Guarrera; J, Cooper; Garatti, Marco; Emre, Sukru; Guy,; Me, Schwartz; Cm, Miller

doi:10.1097/00007890-199711150-00011

Cited by 132 publications

(82 citation statements)

References 13 publications

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“…However, arterial occlusion resulting in graft loss is a fatal complication and surgical management does not succeed in some cases. 14,15 Therefore, thrombolysis was performed despite the possibility of bleeding complications. Bleeding complications following thrombolysis can be managed by TAE or surgical ligation.…”

Section: Discussionmentioning

confidence: 99%

Endovascular treatment of acute arterial complications after living-donor liver transplantation

et al. 2008

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Section: Discussionmentioning

confidence: 99%

Endovascular treatment of acute arterial complications after living-donor liver transplantation

et al. 2008

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“…Regular scanning of the hepatic artery (HA) with the colour duplex scan can detect HA stenosis before complete HA occlusion, and HA stenosis can be successfully treated with angioplasty [ 141. Careful monitoring for HAT and early intervention can be effective in patients with HAT after OLT [8,15,16,17,181.…”

Section: Arterial Conduits For Hepatic Artery Revascularisation In Admentioning

confidence: 99%

Arterial conduits for hepatic artery revascularisation in adult liver transplantation

Muralidharan¹,

Imber²,

Leelaudomlipi³

et al. 2004

Transplant International

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Arterial complications after orthotopic liver transplantation (OLT), including hepatic artery thrombosis (HAT), are important causes of early graft failure. The use of an arterial conduit is an accepted alternative to the utilisation of native recipient hepatic artery for specific indications. This study aims to determine the efficacy of arterial conduits and the outcome in OLT. We retrospectively reviewed 1,575 cadaveric adult OLTs and identified those in which an arterial conduit was used for hepatic revascularisation. Data on the primary disease, indication for using arterial conduit, type of vascular graft, operative technique and outcome were obtained. Thirtysix (2.3%) patients underwent OLT in which arterial conduits were used for hepatic artery (HA) revascularisation. Six of these were performed on the primary transplant, while the rest (n = 30) were performed in patients undergoing re-transplantation, including six who had developed hepatic artery aneurysms. The incidence of arterial conduits was 0.4% (6/ 1,426 cases) in all primary OLTs and 20.1% (30/149 cases) in all re-transplants. Twenty-nine procedures utilised iliac artery grafts from the same donor as the liver, six used iliac artery grafts from a different donor, and a single patient underwent a polytetrafluoroethylene (PTFE) graft. Two techniques were used: infra-renal aorto-hepatic artery conduit and interposition between the donor and recipient native HAS, or branches of the HAS. The 30-day mortality rate for operations using an arterial conduit was 30.6%. Three conduits thrombosed at 9,25 and 155 months, respectively, but one liver graft survived without re-transplantation. The arterial conduits had 1-and 5-year patency rates of 88.5% and 80.8%. The 1-and 5-year patient survival rates were 66.7% and 44%. We can thus conclude that an arterial conduit is a viable alternative option for hepatic revascularisation in both primary and re-transplantation. Despite a lower patency rate than that of native HA in the primary OLT group, the outcomes of arterial conduit patency and patient survival rates are both acceptable at 1 and 5 years, especially in the much larger re-OLT group.

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“…Emergency revascularization is sometimes an effective means of hepatic allograft salvage; nevertheless, many patients eventually require retransplantation. 99,100 Late-onset HAT has a more benign course. 101 Although often asymptomatic because of adequate portal vein flow or collateral circulation, in about 20% to 67% of patients, HAT is associated with progressive graft failure that requires retransplantatation.…”

Section: Hepatic Artery Thrombosis and Stenosismentioning

confidence: 99%

Intrahepatic cholestasis after liver transplantation

Ben‐Ari

Pappo

Mor

2003

Liver Transplantation

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Cholestasis is a common sequela of liver transplantation. Although the majority of cases remain subclinical, severe cholestasis may be associated with irreversible liver damage, requiring retransplantation. Therefore, it is essential that clinicians be able to identify and treat the syndromes associated with cholestasis. In this review, we consider causes of intrahepatic cholestasis. These may be catego-

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Selective Revascularization of Hepatic Artery Thromboses After Liver Transplantation Improves Patient and Graft Survival1

Cited by 132 publications

References 13 publications

Endovascular treatment of acute arterial complications after living-donor liver transplantation

Endovascular treatment of acute arterial complications after living-donor liver transplantation

Arterial conduits for hepatic artery revascularisation in adult liver transplantation

Intrahepatic cholestasis after liver transplantation

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