RISK FACTORS ASSOCIATED WITH HEPATIC ARTERY THROMBOSIS: ANALYSIS OF 1050 LIVER TRANSPLANTS

Overview

Journal Arq Bras Cir Dig

Specialties Gastroenterology
General Surgery

Date 2021 Jan 27

PMID 33503116

Citations 11

Authors

Luis Eduardo Veras Pinto

Gustavo Rego Coelho

Madalena Maria Silva Coutinho

Orlando Jorge Martins Torres

Plinio Cunha Leal

Ciro Bezerra Vieira

Jose Huygens Parente Garcia

Affiliations

Soon will be listed here.

Abstract

Background: Hepatic artery thrombosis is an important cause of graft loss and ischemic biliary complications. The risk factors have been related to technical aspects of arterial anastomosis and non-surgical ones.

Aim: To evaluate the risk factors for the development of hepatic artery thrombosis.

Methods: The sample consisted of 1050 cases of liver transplant. A retrospective and cross-sectional study was carried out, and the variables studied in both donor and recipient.

Results: Univariate analysis indicated that the variables related to hepatic artery thrombosis are: MELD (p=0.04) and warm time ischemia (p=0.005). In the multivariate analysis MELD=14.5 and warm ischemia time =35 min were independent risk factors for hepatic artery thrombosis. In the prevalence ratio test for analysis of the anastomosis as a variable, it was observed that patients with continuous suture had an increase in thrombosis when compared to interrupted suture.

Conclusions: Prolonged warm ischemia time, calculated MELD and recipient age were independent risk factors for hepatic artery thrombosis after liver transplantation in adults. Transplanted patients with continuous suture had an increase in thrombosis when compared to interrupted suture. Re-transplantation due to hepatic artery thrombosis was associated with higher recipient mortality.

Citing Articles

Transposition of the gastroduodenal artery for vascular reconstruction of invasive lesion of the hepatic hilum due to colorectal adenocarcinoma metastasis: case report.

de Oliveira L, Saldanha I, Barbosa Y, Leal R, Sampaio A, Goes A J Vasc Bras. 2025; 23():e20240012.

PMID: 39866169 PMC: 11758930. DOI: 10.1590/1677-5449.202400122.

Use of Intraoperative Doppler Ultrasonography in Predicting Life-Threatening Vascular Complications After Adult Deceased Donor Liver Transplantation.

OLeary C, Spence S, Wells R, Sculley D, Bettag J, Okeke R Cureus. 2024; 16(11):e73588.

PMID: 39677090 PMC: 11645160. DOI: 10.7759/cureus.73588.

Comparison of Vascular Complications Between Living-donor and Deceased-donor Liver Transplantation - A Systematic Review and Meta-analysis.

Giri S, Panigrahi S, Mohapatra V, Nath P, Sahu S, Mallick B J Clin Exp Hepatol. 2024; 15(1):102414.

PMID: 39494314 PMC: 11525129. DOI: 10.1016/j.jceh.2024.102414.

Prediction of hepatic artery occlusion after liver transplantation by ultrasound characteristics and clinical risk factors.

Lai Y, Chen Y, Fang T, Li Z, Zhao N World J Radiol. 2024; 16(6):196-202.

PMID: 38983843 PMC: 11229943. DOI: 10.4329/wjr.v16.i6.196.

LIVER TRANSPLANTATION IN PATIENTS WITH PRIMARY SCLEROSING CHOLANGITIS: A MULTICENTRIC STUDY.

Wiederkehr H, Wiederkehr J, da Igreja M, Ramos E, Nogara M, Soffiatti D Arq Bras Cir Dig. 2023; 36:e1769.

PMID: 37851755 PMC: 10578153. DOI: 10.1590/0102-672020230051e1769.

References

Freitas A, Rampim A, Nunes C, Coelho J . IMPACT OF MELD SODIUM ON LIVER TRANSPLANTATION WAITING LIST. Arq Bras Cir Dig. 2019; 32(3):e1460. PMC: 6902892. DOI: 10.1590/0102-672020190001e1460. View

Mori K, Nagata I, Yamagata S, Sasaki H, Nishizawa F, Takada Y . The introduction of microvascular surgery to hepatic artery reconstruction in living-donor liver transplantation--its surgical advantages compared with conventional procedures. Transplantation. 1992; 54(2):263-8. DOI: 10.1097/00007890-199208000-00014. View

Rela M, Heaton N, Muiesan P, Tan K . A technique for hepatic artery anastomosis during orthotopic liver transplantation. Transpl Int. 1995; 8(3):244-5. DOI: 10.1007/BF00336546. View

Shaked A, McDiarmid S, Harrison R, Gelebert H, Colonna 3rd J, Busuttil R . Hepatic artery thrombosis resulting in gas gangrene of the transplanted liver. Surgery. 1992; 111(4):462-5. View

Zhao J, Lu S, Yan L, Li B, Wen T, Zeng Y . Incidence and treatment of hepatic artery complications after orthotopic liver transplantation. World J Gastroenterol. 2003; 9(12):2853-5. PMC: 4612070. DOI: 10.3748/wjg.v9.i12.2853. View

Singhal A, Stokes K, Sebastian A, Wright H, Kohli V . Endovascular treatment of hepatic artery thrombosis following liver transplantation. Transpl Int. 2009; 23(3):245-56. DOI: 10.1111/j.1432-2277.2009.01037.x. View

Li P, Jeng L, Yang H, Lee C, Poon K, Chen T . Hepatic artery reconstruction in living donor liver transplantation: running suture under surgical loupes by cardiovascular surgeons in 180 recipients. Transplant Proc. 2012; 44(2):448-50. DOI: 10.1016/j.transproceed.2012.01.059. View

Piscaglia F, Vivarelli M, La Barba G, Morselli-Labate A, Taddei S, Cucchetti A . Analysis of risk factors for early hepatic artery thrombosis after liver transplantation. Possible contribution of reperfusion in the early morning. Dig Liver Dis. 2006; 39(1):52-9. DOI: 10.1016/j.dld.2006.08.004. View

Oh C, Pelletier S, Sawyer R, Dacus A, McCullough C, Pruett T . Uni- and multi-variate analysis of risk factors for early and late hepatic artery thrombosis after liver transplantation. Transplantation. 2001; 71(6):767-72. DOI: 10.1097/00007890-200103270-00014. View

10.

Calne R, Williams R . Liver transplantation in man. I. Observations on technique and organization in five cases. Br Med J. 1968; 4(5630):535-40. PMC: 1912414. DOI: 10.1136/bmj.4.5630.535. View

11.

Drazan K, Shaked A, Olthoff K, Imagawa D, Jurim O, Kiai K . Etiology and management of symptomatic adult hepatic artery thrombosis after orthotopic liver transplantation (OLT). Am Surg. 1996; 62(3):237-40. View

12.

Zheng S, Yu Z, Liang T, Wang W, Shen Y, Zhang M . Prevention and treatment of hepatic artery thrombosis after liver transplantation. Hepatobiliary Pancreat Dis Int. 2004; 3(1):21-5. View

13.

Al Sebayel M, Ramirez C, Hussien R . Outcome and risk factors of hepatic artery thrombosis after orthotopic liver transplantation in adults. Transplant Proc. 2001; 33(5):2712-3. DOI: 10.1016/s0041-1345(01)02157-1. View

14.

Stange B, Glanemann M, Nuessler N, Settmacher U, Steinmuller T, Neuhaus P . Hepatic artery thrombosis after adult liver transplantation. Liver Transpl. 2003; 9(6):612-20. DOI: 10.1053/jlts.2003.50098. View

15.

Varotti G, Grazi G, Vetrone G, Ercolani G, Cescon M, Del Gaudio M . Causes of early acute graft failure after liver transplantation: analysis of a 17-year single-centre experience. Clin Transplant. 2005; 19(4):492-500. DOI: 10.1111/j.1399-0012.2005.00373.x. View

16.

Marudanayagam R, Shanmugam V, Sandhu B, Gunson B, Mirza D, Mayer D . Liver retransplantation in adults: a single-centre, 25-year experience. HPB (Oxford). 2010; 12(3):217-24. PMC: 2889275. DOI: 10.1111/j.1477-2574.2010.00162.x. View

17.

Bekker J, Ploem S, de Jong K . Early hepatic artery thrombosis after liver transplantation: a systematic review of the incidence, outcome and risk factors. Am J Transplant. 2009; 9(4):746-57. DOI: 10.1111/j.1600-6143.2008.02541.x. View

18.

Lisman T, Porte R . Hepatic artery thrombosis after liver transplantation: more than just a surgical complication?. Transpl Int. 2008; 22(2):162-4. DOI: 10.1111/j.1432-2277.2008.00762.x. View

19.

Sevmis S, Karakayali H, Tutar N, Boyvat F, Ozcay F, Torgay A . Management of early hepatic arterial thrombosis after pediatric living-donor liver transplantation. Transplant Proc. 2011; 43(2):605-8. DOI: 10.1016/j.transproceed.2011.01.011. View

20.

Reyes-Corona J, Gonzalez-Huezo M, Zea-Medina M, Zamora-Valdes D, Victoria-Campos J, Mondragon-Sanchez R . Paclitaxel coated-stent for early-onset thrombosis after liver transplantation. Ann Hepatol. 2007; 6(4):272-5. View