title: Intimal dissection of the hepatic artery after thrombectomy as a cause of graft loss in pediatric living-related liver transplantation.
abstract: 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.
authors.affiliation: Instituto da Criança, University of São Paulo, Medical School, São Paulo, Brazil. maksoudf@icr.hcnet.usp.br
authors.forename: João Gilberto
authors.initials: JG
authors.lastname: Maksoud-Filho
authors.forename: Uenis
authors.initials: U
authors.lastname: Tannuri
authors.forename: Nelson Elias Mendes
authors.initials: NE
authors.lastname: Gibelli
authors.forename: Maria Lucia
authors.initials: ML
authors.lastname: de Pinho-Appezzato
authors.forename: Marcos Marques
authors.initials: MM
authors.lastname: da Silva
authors.forename: Ali Abdoul Rahman
authors.initials: AA
authors.lastname: Ayoub
authors.forename: Maria Mercês
authors.initials: MM
authors.lastname: Santos
authors.forename: Manoel Carlos Prieto
authors.initials: MC
authors.lastname: Velhote
authors.forename: Evandro Sobrosa
authors.initials: ES
authors.lastname: de Mello
authors.forename: Eduardo Sobrosa
authors.initials: ES
authors.lastname: de Mello
authors.forename: João Gilberto
authors.initials: JG
authors.lastname: Maksoud
mesh_terms: 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*