Arch Surg 1990 May;125(5):628-31

Hepatic artery reconstruction for hepatic artery thrombosis after orthotopic
liver transplantation

Yanaga K, Lebeau G, Marsh JW, Gordon RD, Makowka L, Tzakis AG, Todo S, Stieber
AC, Iwatsuki S, Starzl TE

Department of Surgery, University of Pittsburgh School of Medicine, PA 15213

Abstract

We evaluated the efficacy of reconstruction of the hepatic artery for
intraoperative or postoperative thrombosis in orthotopic liver transplantation.
Of 37 grafts with artery thrombosis, 13 (35.1%, 6 intraoperative and 7
postoperative) underwent reconstruction of the hepatic artery. The arterial flow
was reestablished and maintained in 5 (38.5%) of the 13. Recurrent thrombosis in
the other 8 grafts developed 2 to 24 days (mean, 13.8 days) after
transplantation. Reconstruction was successful in 50% (4/8) of the adults,
compared with only 20% (1/5) of the children. Satisfactory results were obtained
when a definitive cause of thrombosis could be identified. We conclude that
early recognition and correction of the cause of hepatic artery thrombosis
during or after orthotopic liver transplantation, especially in adults, is often
a graft-saving and lifesaving procedure worthy of consideration