BACKGROUND: Hepatic artery thrombosis (HAT) is a common complication of liver transplantation which causes lots of graft loss. The anastomoses of hepatic artery requires delicate work and technically well trained.

METHODS: We retrospectively analyzed patients with HAT complications in the consecutive liver transplant recipients between January 2015 and December 2016. HAT complications were found by color doppler ultrasound and contrast-enhance ultrasound, further confirmed with computed tomographic angiography and direct angiography when needed. The thrombolytic therapy program includes local urokinase, systemic aspirin and low molecular weight heparin.

RESULTS:Hepatic arterial complications occurred in 11 of 228 recipients (4.8%) within a median of 5 post-transplant days (range, 1-30). To treat these complications,interventional radiology therapywas performed in 9 cases, while the other 2 cases underwent conservative therapies followed by retransplantation and immediately surgical re-anastomosis. Only one third of interventional thrombolytic therapy patients acquired repetency of occlusive hepatic artery. 2 cases were treated by surgical re-anastomosis, and 2 cases proceeded to retransplantation following interventional therapy. Interestingly, there were two cases of HAT patient that presented as normal liver function with occlusive hepatic artery, which did not show biliary complications in 1-year follow-up. All recipients were followed up for 1 to 21 month, with a median of 8 month. There were no intraoperative deaths, but mortality occurred in 1 of those 11 patients because of intraperitoneal bleeding after thrombolytic therapy.

CONCLUSION: Hepatic artery thrombosis is a devastating complication after liver transplantation and should be taken seriously due to its destructive damage to liver donor. Early diagnosis and immediate treatment are crucial for patient prognosis. Interventional thrombolytic therapy and surgical anastomosis are effective methods for the revascularization of liver donor, while liver retransplantation, the final program, depends on donor availability.

CITATION INFORMATION: Chen M, Lin X, Ju W, Wang D, Ma Y, Wu L, He X, Chen G. Effective Thrombolytic Therapy of Hepatic Artery Thrombosis After Liver Transplantation – A Single-Center Experience. Am J Transplant. 2017;17 (suppl 3).

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