Evaluation of Early and Late Effects of Surgical Treatment of Early Hepatic Artery Thrombosis After Liver Transplantation |
| |
| Institution: | 1. Liver and Internal Medicine Unit, Medical University of Warsaw, Warsaw, Poland;2. Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland;3. Medical University of Warsaw, Warsaw, Poland;1. Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Zabrze, Poland;2. Department of Cardiac Transplantation and Mechanical Circulatory Support, Silesian Center for Heart Diseases, Zabrze, Poland;3. Cardiac Surgery, Transplantology and Mechanical Circulatory Support in Children, Silesian Center for Heart Diseases, Zabrze, Poland;1. Department of Nephrology, Dialysis and Internal Medicine, Medical University of Warsaw, Warsaw, Poland;2. Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warsaw, Poland;3. Department of Clinical Medicine, Medical University of Bialystok, Bialystok, Poland;1. Department of General Surgery and Transplantology, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warsaw, Poland;2. Centre of Postgraduate Medical Education, Warsaw, Poland;1. President of Polish Transplantation Society;2. President Elect of Polish Transplantation Society |
| |
| Abstract: | BackgroundHepatic artery thrombosis (HAT) is the most severe vascular complication after liver transplantation and one of the major causes of early graft loss and mortality after transplantation. The number of retransplantations and recipient deaths can be decreased with an urgent thrombectomy of the hepatic artery.The aim of the study was to analyze the early and long-term outcomes of the surgical revascularization of early hepatic artery thrombosis after liver transplantation.MethodsFour hundred eleven orthotopic liver transplantations in 380 patients were performed at our center between 2005 and 2020. A Doppler evaluation of the graft vessels patency was performed daily for the first 5 days after transplantation in all recipients. After angio–computed tomography confirmation, most of the cases of HAT qualified for surgical revascularization.ResultsEarly HAT was diagnosed in 20 cases (4.9%), occurring most frequently between the first and third day after transplantation. Sixteen patients underwent revascularization surgery. Among them, in the early post-transplantation period, 4 died and 2 more had retransplantation. Of the remaining 10 recipients, 2 had no biliary complications, 1 had bile leakage, and 7 had common bile duct stenosis, all treated endoscopically. Among 4 nonoperated patients, 1 died and the other 2 had retransplantation in the early post-transplantation period; the last of these 4 recipients had bile duct stenosis.ConclusionsThe urgent surgical revascularization in liver recipients with early HAT allows the avoidance of early retransplantation. However, these patients require intensified surveillance owing to the high risk of biliary complications that may affect shortened graft and patient survival. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
