Vascular complications in the first 100 liver transplantations in Saudi Arabia.

Vascular complications are a significant cause of morbidity and mortality following liver transplantation. The purpose of this study is to determine the impact of vascular complications on the patient and graft survival. One hundred liver transplant procedures were performed on 92 patients between January 1994 and June 1998 at King Fahad Hospital (Riyadh, Saudi Arabia). Patients' data were analyzed retrospectively with special emphasis on vascular complications. Vascular complication occurred in 19 procedures (19%), including HAT (n = 8), IVC stenosis (n = 3), PVT (n = 2), HAS (n = 2), rupture HA mycotic aneurysm (n = 1), and celiac artery stenosis (n = 1). Combined vascular complication occurred in 2 patients (HAT and PVT, and HAS and IVC stenosis). The only significant risk factor for the development of vascular thrombosis in our study was pediatric age. The use of low-dose heparin was found to be a protective factor against HAT (P = 0.03). Complications were managed by thrombectomy (n = 2), thrombectomy followed by retransplantation (n = 3), retransplantation (n = 2), and revision (n = 2). Nonsurgical approaches included angioplasty (n = 6) and observation (n = 4). The overall survival rate was 65% (13 of 20). HAT is the most serious complication following liver transplantation; it may lead to death. Timely retransplantation may salvage some patients, and angioplasty is useful in the management of vascular stenoses.