title: Hepatic artery thrombosis after orthotopic liver transplant: a review of the same institute 5 years later.
abstract: OBJECTIVE
  Summarize the experience of managing patients with hepatic artery thrombosis after orthotopic liver transplant in a single center.
  
  
  METHODS
  A total of 726 adult patients who received a liver transplant at the Department of Organ Transplantation, the First Affiliated Hospital of Sun Yat-Sen University, between January 2004 and December 2009, were selected. Fourteen patients had hepatic artery thrombosis after the operation, and the clinical data of these patients were analyzed retrospectively.
  
  
  RESULTS
  The incidence rate of hepatic artery thrombosis was 1.9% (14/726), and the mean time of onset was 10 days (range, 1-41 d) after surgery. Six patients had acute deterioration of liver function, 4 had bile leakage, 1 had hepatic abscess, and 3 had no symptoms. Three patients received urgent rearterialization, 2 received intra-arterial thrombolysis, 3 received combined urgent rearterialization and intra-arterial thrombolysis, and 6 patients received a retransplant. The mortality rate associated with hepatic artery thrombosis was 42.9% (6/14); 2 from biliary necrosis and secondary hepatic failure after urgent rearterialization; 1 from recurrent hepatic artery thrombosis and multiple organ failure after intra-arterial thrombolysis; 1 from renal failure and severe infection after combined urgent rearterialization and intra-arterial thrombolysis, and 2 from severe infection after retransplant. The other patients recovered and were followed for 18 to 66 months. Their liver grafts all functioned well with a patent artery. Two died from tumor recurrence at 18 and 29 months after transplant.
  
  
  CONCLUSIONS
  Hepatic artery thrombosis is a severe complication after liver transplant, which leads to graft loss and recipient death. Rearterialization as early as possible before irreversible biliary and liver parenchyma damage can avoid retransplant.
authors.affiliation: Department of Organ Transplantation of First Affiliated Hospital, Guangzhou, China.
authors.forename: Linwei
authors.initials: L
authors.lastname: Wu
authors.forename: Jianwei
authors.initials: J
authors.lastname: Zhang
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Guo
authors.forename: Qiang
authors.initials: Q
authors.lastname: Tai
authors.forename: Xiaoshun
authors.initials: X
authors.lastname: He
authors.forename: Weiqiang
authors.initials: W
authors.lastname: Ju
authors.forename: Dongping
authors.initials: D
authors.lastname: Wang
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Zhu
authors.forename: Yi
authors.initials: Y
authors.lastname: Ma
authors.forename: Guodong
authors.initials: G
authors.lastname: Wang
authors.forename: Anbin
authors.initials: A
authors.lastname: Hu
mesh_terms: D000328:Adult; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D002681:China; D006085:Graft Survival; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler