Intimal dissection of the hepatic artery after thrombectomy as a cause of graft loss in pediatric living-related liver transplantation.
HAT is the main cause of graft loss in pediatric living-related LTx. Revascularization of the graft by thrombectomy and re-anastomosis has been reported to be effective for graft salvage in cases of HAT and should be attempted when potential donors are not available for emergency re-transplantation. Immediate complications secondary to revascularization attempts in cases of HAT are not described. Late complications are mainly related to biliary tree ischemia. We report a case of child who experienced intimal hepatic artery dissection, which extended into intra-hepatic branches of the artery after a thrombectomy with a Fogarty balloon catheter in an attempt to restore arterial flow after HAT. This complication led to acute deterioration of the graft and the need for emergency re-transplantation.
Maksoud-Filho
João Gilberto
JG
Instituto da Criança, University of São Paulo, Medical School, São Paulo, Brazil. maksoudf@icr.hcnet.usp.br
Tannuri
Uenis
U
Gibelli
Nelson Elias Mendes
NE
de Pinho-Appezzato
Maria Lucia
ML
da Silva
Marcos Marques
MM
Ayoub
Ali Abdoul Rahman
AA
Santos
Maria Mercês
MM
Velhote
Manoel Carlos Prieto
MC
de Mello
Evandro Sobrosa
ES
de Mello
Eduardo Sobrosa
ES
Maksoud
João Gilberto
JG
D001656:Biliary Atresia; D002404:Catheterization; D002648:Child; D006085:Graft Survival; D006499:Hepatic Artery / Q000473:pathology*; D006801:Humans; D008102:Liver Circulation; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D019520:Living Donors; D012086:Reoperation; D016879:Salvage Therapy; D017131:Thrombectomy; D013927:Thrombosis / Q000209:etiology / Q000601:surgery*; D017539:Tunica Intima / Q000473:pathology*