Treatment of hepatic artery thrombosis after orthotopic liver transplantation.
OBJECTIVE
This study evaluated conservative treatment for delayed hepatic artery thrombosis after orthotopic liver transplantation (OLT).


METHODS
Whole-graft OLTs (n=108) and live donor liver transplants (LDLTs; n=140) were performed in 237 patients between October 1991 and July 2002. Seven episodes of hepatic artery thrombosis were identified in six patients. Among the six patients, three had received whole-graft OLT and three had received right-lobe LDLT. Treatment included retransplantation, thrombectomy plus thrombolysis, and conservative treatment of hepatic and biliary complications.


RESULTS
Five patients survived after treatment. Among the three LDLT recipients who received conservative treatment, two had subsequent collateral formation and one had spontaneous recanalization of arterial inflow. Of the three recipients of whole-graft OLT, the first died because of hepatic failure and technically difficult retransplantation, the second had thrombectomy plus thrombolysis but had recurrence of thrombosis that spontaneously recannulated during conservative treatment, and the third patient had successful retransplantation for graft failure.


CONCLUSIONS
In the absence of hepatic failure, conservative treatment appears to be effective for patients with hepatic artery thrombosis. Collateralization is more likely to develop after LDLT than after whole-graft OLT.
Tian
Ming Guo
MG
Department of Surgery, The University of Hong Kong, Hong Kong SAR, China.
Tso
Wai Kuen
WK
Lo
Chung Mau
CM
Liu
Chi Leung
CL
Fan
Sheung Tat
ST
D000328:Adult; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D017131:Thrombectomy; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000628:therapy*