title: Continuous intraarterial thrombolysis for early hepatic artery thrombosis following liver transplantation: case report.
abstract: Hepatic artery thrombosis remains one of the major causes of graft failure and mortality in liver transplant recipients. Urgent re-transplantation has been considered as mainstay therapy; however, even with re-transplantation mortality of more than 50% has been reported by many series. Early detection on Doppler ultrasonography and subsequent revascularization in asymptomatic patients can avoid graft loss. Endovascular therapy including intra-arterial thrombolysis, percutaneous transluminal angioplasty, and stent placement have shown encouraging results in recent years; nevertheless, their use remains controversial due to potential risk of bleeding. We present a case of early hepatic artery thrombosis following liver transplantation treated successfully with continuous transcatheter intra-arterial thrombolysis using tissue plasminogen activator (t-PA).
authors.affiliation: Nazih Zuhdi Transplant Institute, INTEGRIS Baptist Medical Center, Oklahoma City, Oklahoma, USA.
authors.forename: Ashish
authors.initials: A
authors.lastname: Singhal
authors.forename: Indraneil
authors.initials: I
authors.lastname: Mukherjee
authors.forename: Kenneth
authors.initials: K
authors.lastname: Stokes
authors.forename: Harlan I
authors.initials: HI
authors.lastname: Wright
authors.forename: Anthony
authors.initials: A
authors.lastname: Sebastian
authors.forename: Vivek
authors.initials: V
authors.lastname: Kohli
mesh_terms: D000368:Aged; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006085:Graft Survival; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007261:Infusions, Intra-Arterial; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D011859:Radiography; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator