Hepatic artery thrombosis after pediatric liver transplantation a medical or surgical event

Mazzaferro Vincenzo, Esquivel Carlos, Makowka Leonard, Belle Steven, Kahn Delawir, Koneru Baburao, P. Scantlebury Velma, C. Stieber Andrei, Todo Satoru, G. Txakis Andres, E. Starzl Thomas

Research output: Contribution to journalArticlepeer-review

198 Scopus citations

Abstract

Hepatic artery thrombosis (HAT) is one of the most serious complications after orthotopic liver transplan¬tation, and is associated with a high morbidity and mor¬tality. This study retrospectively reviewed 66 liver transplants in children under the age of 10 years during1 a year-long period at a single institution.;A, total of 28 perioperative variables were analyzed to identify responsible factors of HAT. Of the 66 children, 18 (26%) developed HAT within 15 days after the transplant (HAT group); 29 (42%) had an uneventful postoperative course (control group). To avoid the possible influence of other complications 19 patients were excluded. Of the variables compared between the 2 study groups, three surgical factors (diameter of the hepatic artery-- greater or less than 3 mm; type of arterial anastomosis—end-to-end versus the use of an iliac graft or aortic conduit; and number of times the anastomosis was redone--one versus more than one), were found to be significantly different (P<.05) between HAT and control groups. Two medical factors also were significantly different: the use of intraoperative transfusion of fresh frozen plasma (FFP) and the administration of postoperative prophylactic anticoagulant treatment. A heparin and dextran-40 protocol appeared to be effective in preventing HAT (P<.02). Moreover, after multivariate analysis, anticoagulation therapy was demonstrated to with poor hepatic artery flow.

Original languageEnglish (US)
Pages (from-to)971-977
Number of pages7
JournalTransplantation
Volume47
Issue number6
DOIs
StatePublished - Jun 1989
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Transplantation

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