title: Management of early hepatic artery occlusion after liver transplantation with failed rescue.
abstract: Hepatic artery thrombosis is a serious complication after liver transplantation which often results in biliary complications, early graft loss, and patient death. It is generally thought that early hepatic artery thrombosis without urgent re-vascularization or re-transplantation almost always leads to mortality, especially if the hepatic artery thrombosis occurs within a few days after transplantation. This series presents 3 cases of early hepatic artery thrombosis after living donor liver transplantation, in which surgical or endovascular attempts at arterial re-vascularization failed. Unexpectedly, these 3 patients survived with acceptable graft function after 32 mo, 11 mo, and 4 mo follow-up, respectively. The literatures on factors affecting this devastating complication were reviewed from an anatomical perspective. The collective evidence from survivors indicated that modified nonsurgical management after liver transplantation with failed revascularization may be sufficient to prevent mortality from early hepatic artery occlusion. Re-transplantation may be reserved for selected patients with unrecovered graft function.
authors.affiliation: Chih-Yang Hsiao, Cheng-Maw Ho, Yao-Ming Wu, Ming-Chih Ho, Rey-Heng Hu, Po-Huang Lee, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan.
authors.forename: Chih-Yang
authors.initials: CY
authors.lastname: Hsiao
authors.affiliation: Chih-Yang Hsiao, Cheng-Maw Ho, Yao-Ming Wu, Ming-Chih Ho, Rey-Heng Hu, Po-Huang Lee, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan.
authors.forename: Cheng-Maw
authors.initials: CM
authors.lastname: Ho
authors.affiliation: Chih-Yang Hsiao, Cheng-Maw Ho, Yao-Ming Wu, Ming-Chih Ho, Rey-Heng Hu, Po-Huang Lee, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan.
authors.forename: Yao-Ming
authors.initials: YM
authors.lastname: Wu
authors.affiliation: Chih-Yang Hsiao, Cheng-Maw Ho, Yao-Ming Wu, Ming-Chih Ho, Rey-Heng Hu, Po-Huang Lee, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan.
authors.forename: Ming-Chih
authors.initials: MC
authors.lastname: Ho
authors.affiliation: Chih-Yang Hsiao, Cheng-Maw Ho, Yao-Ming Wu, Ming-Chih Ho, Rey-Heng Hu, Po-Huang Lee, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan.
authors.forename: Rey-Heng
authors.initials: RH
authors.lastname: Hu
authors.affiliation: Chih-Yang Hsiao, Cheng-Maw Ho, Yao-Ming Wu, Ming-Chih Ho, Rey-Heng Hu, Po-Huang Lee, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan.
authors.forename: Po-Huang
authors.initials: PH
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D003251:Constriction, Pathologic; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D017211:Treatment Failure
keywords: Complication; Hepatic artery; Liver transplantation; Revascularization; Thrombosis