title: Revision liver transplant for persistent infection and localized aspergillosis after hepatic artery thrombosis.
abstract: Early hepatic artery thrombosis after liver transplant may be complicated by aggressive aspergillosis and bacterial infections that may cause morbidity and mortality. The definitive treatment of hepatic artery thrombosis is revision transplant. However, sepsis may be a contraindication to revision transplant. A 37-year-old man developed hepatic artery thrombosis at 3 days after liver transplant. During the treatment of hepatic artery thrombosis, he developed multiple biliary, bacterial, and fungal infections. Evaluation showed aspergillosis with multiple intrahepatic abscesses. He was treated with antibiotic and antifungal drugs. Despite active sepsis, revision transplant was performed and the infection resolved. Although sepsis may be a contraindication for transplant surgery, revision transplant was successful, probably because the primary transplanted liver was the source of infection.
authors.affiliation: Department of General Surgery, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Jafarian
authors.forename: Amir
authors.initials: A
authors.lastname: Kasraianfard
authors.forename: Mohssen
authors.initials: M
authors.lastname: Nassiri-Toosi
mesh_terms: D000151:Acinetobacter Infections / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D040981:Acinetobacter baumannii / Q000302:isolation & purification*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D001228:Aspergillosis / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D003251:Constriction, Pathologic; D006499:Hepatic Artery / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008100:Liver Abscess / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D012086:Reoperation; D018805:Sepsis / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents