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Urgent revascularization of liver allografts after early hepatic artery thrombosis

Pinna, AD and Smith, CV and Furukawa, H and Starzl, TE and Fung, JJ (1996) Urgent revascularization of liver allografts after early hepatic artery thrombosis. Transplantation, 62 (11). 1584 - 1587. ISSN 0041-1337

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Abstract

Between April 1993 and May 1995, 17 adult orthotopic liver transplant recipients were found to have early hepatic artery thrombosis (HAT) after a median of 7 postoperative days (mean, 11). The HAT was diagnosed in all cases by duplex ultrasound. Thrombectomy was performed with urgent revascularization (UR), using an interposition arterial graft procured from the cadaveric liver donor, and arterial patency was verified with intraoperative angiography. In seven cases, intra-arterial urokinase was administered after the thrombectomy. Fifteen (88%) of the livers remained arterialized throughout the follow-up period (median, 15 months); the remaining two patients developed recurrent HAT after 6 and 8 months. Although there was a high rate of subsequent complications, 11 (65%) of the patients are alive without retransplantation, with a mean follow-up of 17 months. Despite having a patent hepatic artery, the remaining six patients (35%) died from infectious complications that usually were present before the UR. Thus, UR effectively restored arterial inflow in 88% of the patients with early HAT. The ultimate outcome was determined mainly by the presence of intra- abdominal complications at the time of UR. In conclusion, UR, rather than retransplantation, should be considered the prime treatment option for patients who develop early posttransplant HAT.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Pinna, AD
Smith, CV
Furukawa, H
Starzl, TEtes11@pitt.eduTES11
Fung, JJ
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: 15 December 1996
Date Type: Publication
Journal or Publication Title: Transplantation
Volume: 62
Number: 11
Page Range: 1584 - 1587
DOI or Unique Handle: 10.1097/00007890-199612150-00010
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0041-1337
Other ID: uls-drl:31735062134170, Starzl CV No. 1960
Date Deposited: 08 Apr 2010 17:33
Last Modified: 02 Feb 2019 16:56
URI: http://d-scholarship.pitt.edu/id/eprint/5346

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