原位肝移植术后肝动脉血栓形成的诊断和治疗

目的探讨原位肝移植术后肝动脉血栓形成的诊断与治疗。方法回顾性分析我科1996年10月至2004年3月施行的98例次原位肝移植术．其中8例原发性肝癌患者术前有多次TACE史。结果本组病例仅术前有多次TACE史的患者发生肝动脉血栓5例，均经选择性血管造影证实。3例、1例和1例受者分别接受介入溶栓、再血管化手术和再次肝移植。与肝动脉栓塞有关的死亡率为60％(3／5)。结论术前多次TAcE史是移植术后发生肝动脉血栓的高危因素。彩色多普勒超声是监测血管并发症的首选方法。再血管化手术或再次肝移植是治疗肝动脉血栓的有效方案。

THE DIAGNOSIS AND TREATMENT OF HEPATIC ARTERY THROMBOSIS AFTER ORTHOTOPIC LIVER TRANSPLANTATION

Objective To explore the diagnosis and treatment of hepatic artery thrombosis (HAT) after orthotopic liver transplantation (OLT). Method 98 orthotopic liver transplants performed at our center from October , 1996 to March , 2004 were analyzed retrospectively. 8 patients received TACE more than 2 times before OLT. Results 5 patients received TACE developed hepatic artery thrombosis. Interventional procedures, revascularization and retransplantation were performed in 3,1,and 1 of the recipients with HAT respectively. The mortality related to HAT complications was 60% (3/5). Conclusion The history of several times TACE may be the high risk factor of HAT. Colour Doppler Imaging examination is the chief way of monitoring vascular complications following OLT. Revascularization and retransplantation may be the effective therapy for HAT.