title: Repeated graft loss caused by recurrent hepatic artery thrombosis after liver transplantation.
abstract: Hepatic artery thrombosis (HAT) is a main cause of graft loss and patient mortality after orthotopic liver transplantation (OLT). Several surgical and nonsurgical risk factors have been associated with HAT. Retransplantation often is the only possible treatment for this complication; however, the incidence of recurrence of HAT after retransplantation and the underlying conditions of this occurrence have never been investigated. Of 629 consecutive recipients transplanted at a single institution, 24 underwent retransplantion for HAT: in 4 of them (16%), HAT recurred in the second graft; 3 of these patients lost their first graft because of late HAT, whereas another one lost 4 consecutive grafts for early HAT. Antiphospholipid syndrome and paroxysmal nocturnal hemoglobinuria were diagnosed in three and one of these patients, respectively. Recurrent HAT is an uncommon occurrence that, in our experience, was linked to specific thrombophilic conditions; careful screening of these disorders should be included in the pretransplant workup, and adequate prophylaxis is advisable.
authors.affiliation: Dipartimento di Discipline Chirurgiche Rianimatorie e dei Trapianti, Chirurgia II, Policlinico S. Orsola, Bologna, Italy. vivarelli@orsola-malpighi.med.unibo.it
authors.forename: Marco
authors.initials: M
authors.lastname: Vivarelli
authors.forename: Giuliano
authors.initials: G
authors.lastname: La Barba
authors.forename: Cristina
authors.initials: C
authors.lastname: Legnani
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cucchetti
authors.forename: Roberto
authors.initials: R
authors.lastname: Bellusci
authors.forename: Gualtiero
authors.initials: G
authors.lastname: Palareti
authors.forename: Antonino
authors.initials: A
authors.lastname: Cavallari
mesh_terms: D000328:Adult; D006085:Graft Survival; D006499:Hepatic Artery; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D012008:Recurrence; D013927:Thrombosis / Q000453:epidemiology / Q000503:physiopathology*; D017211:Treatment Failure