Session Name: Liver: Retransplantation and Other Complications
Session Date & Time: None. Available on demand.
*Purpose: Hepatic artery thrombosis (HAT) is one of the most severe complications after liver transplantation. It is treated as soon as possible to avoid irreversible time-dependent graft dysfunction.The early finding of arterial complications can lead to an improvement in transplant outcome, through specific clinical surveillance for high-risk cases.The detection of predictive factors for HAT is thus crucial for post-transplant management, with significant repercussions on the survival of the graft and the patient.This work aims to investigate the relationship of donor-related factors with the onset of HAT after liver transplantation.
*Methods: Consecutive liver transplants performed in our Center from November 2006 to July 2020 were retrospectively investigated.The donor parameters considered as predictive factors for HAT were 14: age, gender, body mass index (BMI), alcohol or tobacco abuse, diagnosis of diabetes, hypertension, dyslipidaemia, pre-mortem hypotension or cardiac arrest, pre-mortem use of high-dose (nor)epinephrine, cause of death, cold ischemia time (CIT).The donors were divided according to the post-transplant development of HAT.Categorical variables were compared with the Pearson chi-square test, while continuous variables were analyzed with Student’s T test.Predictive features were analyzed with a binary logistic regression
*Results: In the considered period, 359 liver transplants were performed in our center. The incidence of HAT in the population was 4.1%. The recipients, grouped according to the detection of HAT, showed no demographic or clinical differences.Examining the factors related to the donor, a relationship of HAT was found with death from anoxia (p=0.036), with the over-50 age (p=0.037), with a positive history of cardiovascular disease (p=0.044) or diabetes mellitus (p=0.038).Multivariate analysis of significant parameters showed a strong correlation with post-transplant development of HAT (p <0.0001).
*Conclusions: HAT is one of the most dreaded complications after liver transplantation. It can result in a primary non-function of the graft in the absence of prompt treatment.The development of predictive factors is a good strategy to optimize the search for arterial complications.Our data indicated a good reliability of the donor’s cardiovascular risk factors (age over 50, heart disease, diabetes mellitus, death from anoxia) on the transplant outcome, more reliable when present together.Through the transplant, the graft is moved in the recipient together with its pre-existing history.
To cite this abstract in AMA style:Pascale MM, Moschetta G, Bianco G, Frongillo F, Nure E, Giovinazzo F, Agnes S. Predictive Factors of the Hepatic Artery Thrombosis in Liver Transplantation Through the Analysis of Donor Characteristics [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/predictive-factors-of-the-hepatic-artery-thrombosis-in-liver-transplantation-through-the-analysis-of-donor-characteristics/. Accessed August 3, 2021.
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