title: Analysis of early hepatic artery thrombosis after liver transplantation.
abstract: BACKGROUND
  Hepatic artery thrombosis (HAT) is one of the deadliest complications after orthotopic liver transplantation (OLT). This study aimed to identify risk factors and summarize the experience of HAT management after OLT.
  
  
  METHODS
  Clinical data of 407 adult patients who received OLT in our centres from July 2011 to December 2015 were retrospectively investigated.
  
  
  RESULTS
  The incidence rate of early HAT was 2.0% (8/407). Recipient/donor weight ratio ≥1.15 (P = 0.02), presence of hepatic arterial reconstruction (P < 0.001) and post-operative blood transfusion (P = 0.001) were significantly associated with early HAT in the univariate analysis and the only independent risk factor (odds ratio = 28.49) in binary logistic regression was the presence of hepatic arterial reconstruction. Among patients with early HAT, five received interventional revascularization while two received surgical revascularization and the remaining one received re-transplantation. Their liver grafts were functioning well with patent hepatic artery until their last follow-up, whereas one died from tumor recurrence at 31st month after transplantation.
  
  
  CONCLUSIONS
  The presence of hepatic arterial reconstruction, recipient/donor weight ratio ≥1.15 and post-operative blood transfusion were the main risk factors associated with early HAT. Prompt recognition of these factors, strict surveillance protocols and selective anticoagulation for patients at risk need to be evaluated. For patients with early HAT occurring within a week after transplantation, surgical re-arterialization is preferential while interventional revascularization is recommended when it occurs beyond 7 days after transplantation.
authors.affiliation: Department of Organ Transplantation, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Zhicheng
authors.initials: Z
authors.lastname: Xue
authors.affiliation: Department of Organ Transplantation, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Maogen
authors.initials: M
authors.lastname: Chen
authors.affiliation: Department of Organ Transplantation, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Xuzhi
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Organ Transplantation, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Guodong
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Organ Transplantation, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Xiaoshun
authors.initials: X
authors.lastname: He
authors.affiliation: Department of Organ Transplantation, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Linwei
authors.initials: L
authors.lastname: Wu
authors.affiliation: Department of Organ Transplantation, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Ma
mesh_terms: D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006499:Hepatic Artery; D006801:Humans; D017093:Liver Failure / Q000473:pathology / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D019520:Living Donors; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D015996:Survival Rate; D017131:Thrombectomy / Q000379:methods; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality / Q000601:surgery*
keywords: hepatic artery thrombosis; liver transplantation; management; risk factors