Survival after Late Hepatic Artery Thrombosis
Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, Dallas, TX
Meeting: 2013 American Transplant Congress
Abstract number: A611
Introduction:
Hepatic artery thrombosis (HAT) is associated with poor outcome. In reporting one of the largest series of late HAT our goal is to determine the variables that play a role in patient (pts) survival.
Methods:
From 12/’84 to 07/’11, 3042 primary liver transplants (LTX) were reviewed. Late HAT was defined when happening >30 days post LTX. Donor variables: age, arterial anatomy, backtable reconstruction and long (celiac/splenic patch) or short (proper HA/gastroduodenal artery patch) donor HA. Pts variables: age, gender, race, primary diagnosis, BMI, surgical technique (Veno-venous vs. Piggyback), biliary anastomosis (duct-to-duct vs. Roux-en-Y), intra-operative HA and Portal Vein flows.
Results:
Incidence of Late HAT was 4.2% (129/3042). Data were available on 116pts. Eighty (72%) pts were not (group A) and 36 (28%) were re-transplanted (group B). The 2 groups were compared. Only pts age was significantly different. Group 1 and 2 year survivals was 75% and Group B 92%.
| Variable | Group A No re-transplant (n=80) | Group B Re-transplant (n=36) | p-value |
| Donor variables | |||
| Age (years) | 39 (± 17) | 40 (± 17) | NS |
| Arterial anatomy | NS | ||
| Normal | 54 (67%) | 27 (75%) | |
| Other | 26 (33%) | 9 (25%) | |
| Backtable reconstruction | NS | ||
| Yes | 31 (39%) | 10 (28%) | |
| No | 49 (61%) | 26 (72%) | |
| Anastomosis type | NS | ||
| Short | 5 (6%) | 2 (6%) | |
| Long | 75 (94%) | 34 (94%) | |
| Recipient variables | |||
| Age (years) | 50 (± 12) | 42 (± 9) | 0.0005 |
| Gender | NS | ||
| Male | 39 (49%) | 24 (67%) | |
| Female | 41 (51%) | 12 (33%) | |
| Race | NS | ||
| Black | 3 (4%) | 4 (11%) | |
| White | 68 (85%) | 28 (79%) | |
| Other | 9 (11%) | 4 (11%) | |
| BMI | NS | ||
| 0-30 | 53 (66%) | 26 (72%) | |
| > 30 | 27 (34%) | 10 (28%) | |
| Sugical Technique | NS | ||
| Veno-venous bypass | 75 (93%) | 34 (94%) | |
| Piggyback | 5 (7%) | 2 (6%) | |
| Biliary Anastomosis | NS | ||
| Duct to duct | 75 (93%) | 30 (83%) | |
| Roux en-Y | 5 (7%) | 6 (17%) | |
| Intra-OP HA flow (ml/min) | 443 (± 184) | 496 (± 185) | NS |
| Intra-OP PV flow (ml/min) | 2194 (± 1069) | 1772 (± 724) | NS |
| Cause of Death | frequency |
| Infection | 12 |
| Renal Failure<
To cite this abstract in AMA style: Saeed M, Testa G, Ruiz R, Onaca N, Dabous A, Gupta V, Levy M, Goldstein R, Klintmalm G. Survival after Late Hepatic Artery Thrombosis [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/survival-after-late-hepatic-artery-thrombosis/. Accessed October 30, 2024.« Back to 2013 American Transplant Congress |