title: Risk factors associated with early and late HAT after adult liver transplantation.
abstract: OBJECTIVE
  To identify risk factors that might contribute to hepatic artery thrombosis (HAT) after liver transplantation (LT).
  
  
  METHODS
  The perioperative and follow-up data of a total of 744 liver transplants, performed from February 1999 to July 2010, were retrospectively reviewed. HAT developed in 20 patients (2.7%). HAT was classified as early (occurring in fewer than 30 d post LT) or late (occurring more than 30 d post LT). Early HAT developed in 14 patients (1.9%). Late HAT developed in 6 patients (0.8%). Risk factors associated with HAT were analysed using the χ(2) test for univariate analysis and logistic regression for multivariate analysis.
  
  
  RESULTS
  Lack of ABO compatibility, recipient/donor weight ratio ≥ 1.15, complex arterial reconstruction, duration time of hepatic artery anastomosis > 80 min, duration time of operation > 10 h, dual grafts, number of units of blood received intraoperatively ≥ 7, number of units of fresh frozen plasma (FFP) received intraoperatively ≥ 6, postoperative blood transfusion and postoperative FFP use were significantly associated with early HAT in the univariate analysis (P < 0.1). After logistic regression, independent risk factors associated with early HAT were recipient/donor weight ratio ≥ 1.15 (OR = 4.499), duration of hepatic artery anastomosis > 80 min (OR = 5.429), number of units of blood received intraoperatively ≥ 7 (OR = 4.059) and postoperative blood transfusion (OR = 6.898). Graft type (whole/living-donor/split), duration of operation > 10 h, retransplantation, rejection reaction, recipients with diabetes preoperatively and recipients with a high level of blood glucose or diabetes postoperatively were significantly associated with late HAT in the univariate analysis (P < 0.1). After logistic regression, the independent risk factors associated with early HAT were duration of operation > 10 h (OR = 6.394), retransplantation (OR = 21.793) and rejection reactions (OR = 16.936).
  
  
  CONCLUSIONS
  Early detection of these risk factors, strict surveillance protocols by Doppler ultrasound and prophylactic anticoagulation for recipients at risk might be determined prospectively.
authors.affiliation: Yi Yang, Ji-Chun Zhao, Yu-Kui Ma, Bin Huang, Ding Yuan, Department of Vascular Surgery, Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Yi Yang, Ji-Chun Zhao, Yu-Kui Ma, Bin Huang, Ding Yuan, Department of Vascular Surgery, Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Ji-Chun
authors.initials: JC
authors.lastname: Zhao
authors.affiliation: Yi Yang, Ji-Chun Zhao, Yu-Kui Ma, Bin Huang, Ding Yuan, Department of Vascular Surgery, Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Lu-Nan
authors.initials: LN
authors.lastname: Yan
authors.affiliation: Yi Yang, Ji-Chun Zhao, Yu-Kui Ma, Bin Huang, Ding Yuan, Department of Vascular Surgery, Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Yu-Kui
authors.initials: YK
authors.lastname: Ma
authors.affiliation: Yi Yang, Ji-Chun Zhao, Yu-Kui Ma, Bin Huang, Ding Yuan, Department of Vascular Surgery, Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Huang
authors.affiliation: Yi Yang, Ji-Chun Zhao, Yu-Kui Ma, Bin Huang, Ding Yuan, Department of Vascular Surgery, Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Ding
authors.initials: D
authors.lastname: Yuan
authors.affiliation: Yi Yang, Ji-Chun Zhao, Yu-Kui Ma, Bin Huang, Ding Yuan, Department of Vascular Surgery, Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Li
authors.affiliation: Yi Yang, Ji-Chun Zhao, Yu-Kui Ma, Bin Huang, Ding Yuan, Department of Vascular Surgery, Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Tian-Fu
authors.initials: TF
authors.lastname: Wen
authors.affiliation: Yi Yang, Ji-Chun Zhao, Yu-Kui Ma, Bin Huang, Ding Yuan, Department of Vascular Surgery, Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Wen-Tao
authors.initials: WT
authors.lastname: Wang
authors.affiliation: Yi Yang, Ji-Chun Zhao, Yu-Kui Ma, Bin Huang, Ding Yuan, Department of Vascular Surgery, Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Ming-Qing
authors.initials: MQ
authors.lastname: Xu
authors.affiliation: Yi Yang, Ji-Chun Zhao, Yu-Kui Ma, Bin Huang, Ding Yuan, Department of Vascular Surgery, Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Jia-Yin
authors.initials: JY
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016009:Chi-Square Distribution; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014654:Vascular Patency; D055815:Young Adult
keywords: Blood transfusion; Complication; Hepatic artery thrombosis; Liver transplantation; Risk factors