title: Risk factors for hepatic artery thrombosis after microsurgical vascular reconstruction in liver transplantation.
abstract: OBJECTIVE
  In liver transplantation, microsurgical reconstruction of a hepatic artery is essential but requires challenging techniques. Especially in living-donor liver transplantation, the recipient artery is short and located deep in the abdominal cavity. Furthermore, hepatic artery thrombosis (HAT) can be a lethal complication. This study sought to uncover the risk factors for HAT after microsurgical vascular reconstruction.
  
  
  METHODS
  From 1991 to 2011, we performed 151 microsurgical vascular reconstructions, including 3 deceased-donor liver transplantations. We retrospectively investigated the cases, performing univariate and multivariate analyses to identify independent risk factors for HAT. The patients had undergone ultrasonographic examinations for HAT over the first 14 days after transplantation.
  
  
  RESULTS
  Upon univariate analysis, the risk factors identified to be associated with P < .20 were young age (P = .0484), low body weight (P = .0466), short height (P = .0128), high graft-to-recipient weight ratio (P = .0031), small liver graft volume (P = .0416), small amounts of gabexate mesilate infusion (P = .0516), and the conventional technique (without a back-wall support suture; P = .1326). A multiple logistic regression analysis identified low body weight to be the only independent risk factor for HAT.
  
  
  CONCLUSIONS
  On the univariate analysis, we found that using the back-wall support suture technique contributed to the reduction of HAT, whereas on multivariate analysis, the only independent risk factor for HAT was low body weight.
authors.affiliation: Division of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University, Sendai, Japan. msmsmiyagi@yahoo.co.jp
authors.forename: S
authors.initials: S
authors.lastname: Miyagi
authors.forename: N
authors.initials: N
authors.lastname: Kawagishi
authors.forename: W
authors.initials: W
authors.lastname: Nakanishi
authors.forename: A
authors.initials: A
authors.lastname: Fujio
authors.forename: K
authors.initials: K
authors.lastname: Miyazawa
authors.forename: K
authors.initials: K
authors.lastname: Maida
authors.forename: T
authors.initials: T
authors.lastname: Kashiwadate
authors.forename: Y
authors.initials: Y
authors.lastname: Hara
authors.forename: S
authors.initials: S
authors.lastname: Sekiguchi
authors.forename: N
authors.initials: N
authors.lastname: Ohuchi
authors.forename: S
authors.initials: S
authors.lastname: Satomi
mesh_terms: D000328:Adult; D005260:Female; D006499:Hepatic Artery / Q000473:pathology*; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008866:Microsurgery / Q000009:adverse effects*; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology*