Continuous intraarterial thrombolysis for early hepatic artery thrombosis following liver transplantation: case report.
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).
Singhal
Ashish
A
Nazih Zuhdi Transplant Institute, INTEGRIS Baptist Medical Center, Oklahoma City, Oklahoma, USA.
Mukherjee
Indraneil
I
Stokes
Kenneth
K
Wright
Harlan I
HI
Sebastian
Anthony
A
Kohli
Vivek
V
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
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator