Impact of Hepatic Artery Thrombosis on the Success of a Liver Transplant Because of Hepatocellular Carcinoma.


Journal

Transplantation proceedings
ISSN: 1873-2623
Titre abrégé: Transplant Proc
Pays: United States
ID NLM: 0243532

Informations de publication

Date de publication:
Mar 2020
Historique:
received: 11 10 2019
accepted: 06 11 2019
pubmed: 8 2 2020
medline: 1 9 2020
entrez: 8 2 2020
Statut: ppublish

Résumé

Hepatic artery thrombosis is one of the most serious complications after liver transplant. Our objective is to evaluate the impact of arterial thrombosis on the postoperative evolution of a series of patients who received transplants because of hepatocellular carcinoma. A retrospective study of 100 consecutive hepatocellular carcinoma liver transplants was performed from January 2011 to November 2017. Of the 100 transplant recipients, we have observed hepatic artery thrombosis in 4 of them, 3 premature and 1 delayed. All of them received retransplants after diagnosis by hepatic artery ultrasonography and arteriography. The descriptive analysis showed a significant relationship between the appearance of hepatic artery thrombosis with variables of postoperative severity, such as arrhythmias, atelectasis, pleural effusion, hemodialysis requirement, acute kidney failure, and respiratory failure. Although patients with hepatic artery thrombosis had a longer mean hospital stay, this was not statistically significant. There was decreased graft survival and overall survival of patients who experienced hepatic artery thrombosis. Although the incidence of hepatic artery thrombosis has been relatively low (4%), the early detection of risk factors, such as arterial anatomic anomalies that condition a complex anastomosis, should draw our attention, thus having at our disposal strict ultrasonography and arteriography surveillance protocols as well as prophylactic anticoagulation guidelines for receptors at risk.

Sections du résumé

BACKGROUND BACKGROUND
Hepatic artery thrombosis is one of the most serious complications after liver transplant. Our objective is to evaluate the impact of arterial thrombosis on the postoperative evolution of a series of patients who received transplants because of hepatocellular carcinoma.
METHODS METHODS
A retrospective study of 100 consecutive hepatocellular carcinoma liver transplants was performed from January 2011 to November 2017.
RESULTS RESULTS
Of the 100 transplant recipients, we have observed hepatic artery thrombosis in 4 of them, 3 premature and 1 delayed. All of them received retransplants after diagnosis by hepatic artery ultrasonography and arteriography. The descriptive analysis showed a significant relationship between the appearance of hepatic artery thrombosis with variables of postoperative severity, such as arrhythmias, atelectasis, pleural effusion, hemodialysis requirement, acute kidney failure, and respiratory failure. Although patients with hepatic artery thrombosis had a longer mean hospital stay, this was not statistically significant. There was decreased graft survival and overall survival of patients who experienced hepatic artery thrombosis.
CONCLUSION CONCLUSIONS
Although the incidence of hepatic artery thrombosis has been relatively low (4%), the early detection of risk factors, such as arterial anatomic anomalies that condition a complex anastomosis, should draw our attention, thus having at our disposal strict ultrasonography and arteriography surveillance protocols as well as prophylactic anticoagulation guidelines for receptors at risk.

Identifiants

pubmed: 32029319
pii: S0041-1345(19)31169-8
doi: 10.1016/j.transproceed.2019.11.037
pii:
doi:

Types de publication

Evaluation Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

559-561

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

F Alconchel (F)

Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain. Electronic address: alconchelgago@gmail.com.

L A Martínez-Insfran (LA)

Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain.

P A Cascales-Campos (PA)

Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain.

B Febrero (B)

Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain.

L Martínez-Alarcón (L)

Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain.

A Ríos (A)

Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain.

J A Fernández-Hernández (JA)

Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain.

J M Rodríguez (JM)

Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain.

G Ruiz-Merino (G)

Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain.

M Royo-Villanova (M)

Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain; Intensive Care Unit, Virgen de la Arrixaca University Hospital, Murcia, Spain.

J A Pons (JA)

Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain; Department of Hepatology, Virgen de la Arrixaca University Hospital, Murcia, Spain.

R Robles-Campos (R)

Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain.

F Sánchez-Bueno (F)

Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain.

P Ramírez (P)

Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain.

P Parrilla (P)

Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain.

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