介入治疗肝移植术后肝动脉并发症的初步经验

目的总结采用介入方法治疗肝移植术后并发肝动脉狭窄及血栓形成的初步经验。方法对4例肝移植术后并发肝动脉狭窄或血栓形成的患者行球囊扩张、经动脉溶栓、内支架置入术。结果1例肝动脉狭窄的患者经球囊扩张后临床症状缓解；3例肝动脉血栓形成患者经动脉溶栓后即刻肝动脉血流得到恢复；1例患者溶栓后3d发生吻合口出血，置入带膜支架，症状缓解，1d后肝动脉再次闭塞，2周后行第2次肝移植。结论采用介入方法对肝移植术后并发肝动脉狭窄或血栓形成的患者进行治疗是可行的，但必须谨慎实施，以避免发生出血等并发症。

The preliminary experience of interventional therapy for hepatic arterial complications after liver transplantation

Objective To summarize the preliminary experience of interventional therapy for hepatic arterial stenosis (HAS) and thrombosis (HAT) after liver transplantation.Methods Four patients with HAS or HAT after liver transplantation were treated by percutaneous transluminal angioplasty(PTA), transarterial thrombolysis and stent-graft placement. Results One patient with HAS was successfully treated by percutaneous transluminal angioplasty without any complications. Immediate blood flow of hepatic artery was restored in all of 3 patients with post-transplantation HAT treated by transarterial thrombolysis. Hepatic arterial anastomosis hemorrhage was detected in 1patient 3 days after transarterial thrombolysis and stent-graft was deployed. Two weeks later, her hepatic artery occluded again and secondary liver transplantation was performed. Conclusions Interventional therapy is an effective modality for hepatic arterial stenosis and thrombosis after liver transplantation but they must be performed cautiously to avoid hemorrhagic complications.