AI Article Synopsis
- The study assessed conservative treatment options for delayed hepatic artery thrombosis following liver transplants.
- A total of 237 patients underwent liver transplantation, with seven instances of hepatic artery thrombosis identified among six patients, resulting in various treatment approaches.
- Results showed that conservative treatment was effective, especially in living donor liver transplant recipients, who had better outcomes with collateral blood vessel formation than those who received whole-graft transplants.
Article Abstract
Objectives: This study evaluated conservative treatment for delayed hepatic artery thrombosis after orthotopic liver transplantation (OLT).
Methods: Whole-graft OLTs (n=108) and live donor liver transplants (LDLTs; n=140) were performed in 237 patients between October 1991 and July 2002. Seven episodes of hepatic artery thrombosis were identified in six patients. Among the six patients, three had received whole-graft OLT and three had received right-lobe LDLT. Treatment included retransplantation, thrombectomy plus thrombolysis, and conservative treatment of hepatic and biliary complications.
Results: Five patients survived after treatment. Among the three LDLT recipients who received conservative treatment, two had subsequent collateral formation and one had spontaneous recanalization of arterial inflow. Of the three recipients of whole-graft OLT, the first died because of hepatic failure and technically difficult retransplantation, the second had thrombectomy plus thrombolysis but had recurrence of thrombosis that spontaneously recannulated during conservative treatment, and the third patient had successful retransplantation for graft failure.
Conclusion: In the absence of hepatic failure, conservative treatment appears to be effective for patients with hepatic artery thrombosis. Collateralization is more likely to develop after LDLT than after whole-graft OLT.
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| http://dx.doi.org/10.1016/S1015-9584(09)60035-X | DOI Listing |
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