Abstract:

BACKGROUND: Hepatic artery thrombosis (HAT) is the main reason for graft loss or recipients death after liver transplantation although liver transplantation technology has been maturated.
OBJECTIVE: To summarize the treatment for HAT after orthotopic liver transplantation. 
METHODS: A total of 726 adult patients received liver transplantation at the Department of Organ Transplantation, the First Affiliated Hospital of Sun Yat-sen University from January 2004 to December 2009 were selected. Fourteen patients suffered from HAT after the operation, the clinical data of these patients were analyzed retrospectively.
RESULTS AND CONCLUSION: The incidence rate of HAT was 1.9% (14/726), mean time of the onset was 10 days (1 -41 days) postoperatively. Six of them had acute liver function deterioration, 4 had bile leakage, 1 had hepatic abscess and 3 had no symptoms. Three patients received urgent rearteriarization, 2 received intra-arterial thrombolysis, 3 received combined urgent rearteriarization and intra-arterial thrombolysis, and 6 patients received retransplantation. Mortality rate associated with HAT was 42.9% (6/14), 2 from biliary necrosis and secondary hepatic failure after urgent rearteriarization, 1 from recurrence of HAT and multiple organ failure after intra-arterial thrombolysis, 1 from renal failure and severe infection after combined urgent rearteriarization and intra-arterial thrombolysis, 2 from severe infection after retransplantation. The other patients recovered and were followed up 18-66 months. Their liver grafts were all functioning well with patent artery, 2 died from tumor recurrence at 18 and 29 month after transplantation. HAT is a severe complication after liver transplantation, which leads to graft loss and recipients’ death. Rearteriarization as early as possible before irreversible biliary and liver parenchyma damage can avoid retransplantation.