Hepatic Artery Thrombosis: Related Risk Factors after Liver Transplantation
The purpose of this retrospective study is to evaluate the risk factors hepatic artery thrombosis (HAT) after orthotopic liver transplantation (OLT) in a consecutive series from a single center.
Methods. Between 2011 and 2013, we performed 278 living donor liver transplantations, including 189 males and 89 females. We compared the risk factors between HAT and non-HAT groups according to the following variables: age, gender, body mass index, graft weight, use of graft, Child-Pugh classification and model for end stage liver disease score, level of hemoglobin, blood pressure, operation time, blood transfusion, presence of ascites, international normalized ratio (INR), and etiology.
Results. Eighteen patients, including 15 males and 3 females (mean age — 45.1 years; age range — 22–60 years), had HAT after the operation. There were no pediatric patients in the HAT group. HAT rate was 6.5 % in our series. Graft failure and retransplantation due to HAT was 38.7 % in a 2-year period. Biliary leakage was observed in 72 (25.8 %) living donor liver transplantations; this rate was higher in patients with HAT (44.4 %). The infection rate was 50 % (n = 9) in the HAT group and 32.7 % (n = 91) in the non-HAT group. Mean INR value was 2.15 in the HAT group and 1.72 in the non-HAT group. When we compared the groups according to use of graft for anastomosis, biliary leakage, infection, and INR value, the differences were statistically significant (P < 0.05).
Conclusion. Although the results of OLT have improved over the past years, HAT is still associated with substantial morbidity, high incidence of graft failure, and high mortality rates. The most important findings associated with HAT in our series were found as INR levels, biliary leakage, and resistant infections. Use of vascular graft for hepatic artery anastomosis was found to increase HAT risk.
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