BACKGROUND AND AIM: Hepatic artery thrombosis (HAT) occurs in 3% to 11% of all liver transplantations. Some authors have reported good outcomes with early thrombectomy. To investgate the impact of re-vascularization on graft survival. METHODS: A total of 566 primary, cadaveric, single organ, adult liver transplants were performed. Hepatic arterial Doppler was performed routinely and patients with abnormal findings during the first two post-operative weeks were reexplored. Abnormal findings after this time-point were verified by non-invasive angiogram. The 47 patients that were diagnosed with arterial thrombosis, either intra-operatively or by angiogram, were divided into three groups. No further action was taken for group A, thrombectomy alone was performed for group B1, thrombectomy and anastomotic revision was employed for group B2. RESULTS: Arterial thrombosis was diagnosed in 47 (8.3%) patients. Mean patient survival was 42, 62 and 98 months for groups A, B1 and B2 respectively (p: 0.0629). Mean graft survival was 24, 29 and 60 months for groups A, B1 and B2 respectively (p: 0.3386). Re-transplant incidence was 8.7%, 40% and 28.6% for groups A, B1, and B2 respectively (p: 0.035). CONCLUSIONS: Early diagnosis of HAT by surveillance Doppler may lead to improved recipient survival secondary to earlier re-transplantation and not because of successful graft re-vascularization.
BACKGROUND AND AIM: Hepatic artery thrombosis (HAT) occurs in 3% to 11% of all liver transplantations. Some authors have reported good outcomes with early thrombectomy. To investgate the impact of re-vascularization on graft survival. METHODS: A total of 566 primary, cadaveric, single organ, adult liver transplants were performed. Hepatic arterial Doppler was performed routinely and patients with abnormal findings during the first two post-operative weeks were reexplored. Abnormal findings after this time-point were verified by non-invasive angiogram. The 47 patients that were diagnosed with arterial thrombosis, either intra-operatively or by angiogram, were divided into three groups. No further action was taken for group A, thrombectomy alone was performed for group B1, thrombectomy and anastomotic revision was employed for group B2. RESULTS: Arterial thrombosis was diagnosed in 47 (8.3%) patients. Mean patient survival was 42, 62 and 98 months for groups A, B1 and B2 respectively (p: 0.0629). Mean graft survival was 24, 29 and 60 months for groups A, B1 and B2 respectively (p: 0.3386). Re-transplant incidence was 8.7%, 40% and 28.6% for groups A, B1, and B2 respectively (p: 0.035). CONCLUSIONS: Early diagnosis of HAT by surveillance Doppler may lead to improved recipient survival secondary to earlier re-transplantation and not because of successful graft re-vascularization.
Authors: F Sánchez-Bueno; R Robles; F Acosta; P Ramirez; J Lujan; V Munitiz; A Rios; P Parrilla Journal: Transplant Proc Date: 2000-12 Impact factor: 1.066
Authors: Michael A Silva; Periyathambi S Jambulingam; Bridget K Gunson; David Mayer; John A C Buckels; Darius F Mirza; Simon R Bramhall Journal: Liver Transpl Date: 2006-01 Impact factor: 5.799
Authors: T Karatzas; E Lykaki-Karatzas; M Webb; J Nery; A Tsaroucha; A Demirbas; F Khan; G Ciancio; B Montalvo; R Reddy; E Schiff; J Miller; A G Tzakis Journal: Transplant Proc Date: 1997-11 Impact factor: 1.066
Authors: R F da Silva; R Raphe; H C Felício; M F Rocha; W J Duca; P C J Arroyo; G L Palini; A M Vasquez; D G Miquelin; L F Reis; A A M Silva; R C M A da Silva Journal: Transplant Proc Date: 2008-04 Impact factor: 1.066
Authors: F Sánchez-Bueno; R Robles; P Ramírez; F Acosta; J M Rodríguez; J Luján; J A Pons; J Aguilar; P Parrilla Journal: Clin Transplant Date: 1994-08 Impact factor: 2.863
Authors: John P Duffy; Johnny C Hong; Douglas G Farmer; Rafik M Ghobrial; Hasan Yersiz; Jonathan R Hiatt; Ronald W Busuttil Journal: J Am Coll Surg Date: 2009-05 Impact factor: 6.113
Authors: S Nikeghbalian; K Kazemi; H R Davari; H Salahi; A Bahador; H Jalaeian; M B Khosravi; S Ghaffari; M Lahsaee; M Alizadeh; A R Rasekhi; S M R Nejatollahi; S A Malek-Hosseini Journal: Transplant Proc Date: 2007-05 Impact factor: 1.066
Authors: Thomas Lescot; Constantine J Karvellas; Prosanto Chaudhury; Jean Tchervenkov; Steven Paraskevas; Jeffrey Barkun; Peter Metrakos; Peter Goldberg; Sheldon Magder Journal: Can J Gastroenterol Date: 2013-04 Impact factor: 3.522