title: Liver transplantation and spontaneous neovascularization after arterial thrombosis: "the neovascularized liver".
abstract: The only arterial pathway available after liver transplantation is the hepatic artery. Therefore, hepatic artery thrombosis can result in graft loss necessitating re-transplantation. Herein, we present evidence of neovascularization at long-term follow-up in a series of transplant patients with hepatic artery thrombosis. We termed this phenomenon "neovascularized liver". Hepatic artery thrombosis was noted in 30/407 cases (7.37%), and occurred early in 13 patients (43.3%) and late (>30 days) in 17 (56.7%) patients. At the time of this study, 11 (36.7%) patients had a neovascularized liver. Those patients with neovascularized liver and normal liver function were closely followed. Of these patients, 10 (91%) showed evidence of neovascularized liver by imaging, and an echo-Doppler arterial signal was recorded in all patients. The mean interval between the diagnosis of hepatic artery thrombosis and neovascularized liver was 4.1 months (range of 3-5.5 months). Liver histology showed an arterial structure in 4 (36.4%) patients. Four factors were associated with development of neovascularized liver: late hepatic artery thrombosis, early hepatic artery stenosis, site of thrombosis, and Roux-en-Y anastomosis. The overall survival rate at 54 months was 90.9%. In conclusion, a late hepatic artery thrombosis may be quite uneventful and should not automatically lead to re-transplantation.
authors: Department of General and Liver Transplant Surgery, University of Montpellier, Hôpital Saint Eloi, Montpellier-Cedex 5, France. f-panaro@chu-montpellier.fr
authors: Fabrizio
authors: F
authors: Panaro
authors: Benoit
authors: B
authors: Gallix
authors: Hassan
authors: H
authors: Bouyabrine
authors: Jeanne
authors: J
authors: Ramos
authors: Pietro
authors: P
authors: Addeo
authors: Giuliano
authors: G
authors: Testa
authors: Jean Pierre
authors: JP
authors: Carabalona
authors: George
authors: G
authors: Pageaux
authors: Jacques
authors: J
authors: Domergue
authors: Francis
authors: F
authors: Navarro
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D006499:Hepatic Artery / Q000502:physiology* / Q000601:surgery; D006801:Humans; D008099:Liver / Q000098:blood supply* / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects / Q000502:physiology*; D018919:Neovascularization, Physiologic; D013927:Thrombosis / Q000175:diagnosis / Q000601:surgery