Diagnosis And Treatment Of Hepatic Artery Thrombosis After Liver Transplantation

Objective Through the analysis of clinical cases, summarize the experience in prevention, diagnosis, and management of hepatic artery thrombosis (HAT) after orthotopic liver transplantation. Methods 609 consecutive patients underwent liver transplantation from April 2005 to March 2011 by the same surgery team in our center were retrospectively analyzed. Hepatic arterial blood flow was monitored by color Doppler ultrasound screening daily during the first week after liver transplantation. Abdominal CT examination or hepatic artery angiography was performed on patients with suspected hepatic artery thrombosis (HAT). The patients with diagnosed HAT were treated with operation or interventional therapy. Results 8 patients developed hepatic artery thrombosis after operation in 60 days after operation.The incidence of hepatic artery thrombosis was 1.3% (8/609).3 patients underwent exploratory laparotomy, thrombus dislodgement and hepatic artery re-anastomosis. Two of the three patients died because of biliary and pulmonary complications, the other one underwent a second transplantation because of biliary complications and survived. Interventional therapy was performed in another 5 cases and stents were placed. One of the five patients died because of biliary complications, another one of the five patients underwent a second transplantation because of biliary complications and survived. Other 3 patients live on until today. The mortality of patients with HAT is 37.5%(3/8). Conclusion It is essential to diagnoses HAT by monitoring the artery flow by Doppler ultrasound screening in early period after liver transplantation. HAT may cause serious biliary complications. Thrombectomy, stent placements and re-transplantation are effective therapeutic methods.