Medizinische Universität Graz - Research portal
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SHR Neuro Cancer Cardio Lipid Metab Microb
Müller, SA; Schmied, BM; Mehrabi, A; Welsch, T; Schemmer, P; Hinz, U; Weitz, J; Werner, J; Büchler, MW; Schmidt, J.
Feasibility and effectiveness of a new algorithm in preventing hepatic artery thrombosis after liver transplantation.
J Gastrointest Surg. 2009; 13(4):702-712
Doi: 10.1007/s11605-008-0753-y
Web of Science
PubMed
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- Co-authors Med Uni Graz
- Schemmer Peter
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- Abstract:
- The incidence of hepatic artery thrombosis (HAT) after liver transplantation (LTx) is up to 9% in adult recipients. To minimize HAT, we developed an algorithm that we have routinely applied since 2001. The algorithm is a cascade of potentially necessary procedures to improve hepatic artery blood flow before proceeding with LTx when arterial blood flow is impaired. Incidence, outcome, and possible therapeutic approaches of HAT were analyzed in prospectively non-controlled collected data during a 5-year period. There were 335 LTx in 299 adults (199 male, 100 female) with a median age of 49.7 years. HAT was defined as early and late HAT (diagnosis within or after 30 days following LTx). After a mean follow-up of 17 months, nine HAT were documented (2.7%; five early and four late HAT). Treatment consisted of thrombolysis (n = 1), surgical thrombectomy (n = 4), and re-transplantation (n = 4). Five HAT patients died during follow-up. Complex arterial reconstruction was associated with HAT compared to branch-patch anastomoses (P = 0.0193). Median arterial intraoperative blood flow was no risk factor for HAT. One-year patient survival after HAT was 31%. Once HAT occurs, complication rates are high and long-term results are devastating. Therefore, we have implemented the presented algorithm, which showed an acceptable HAT rate.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Algorithms -
- Anastomosis, Surgical - methods
- Clinical Protocols -
- Feasibility Studies -
- Female -
- Hepatic Artery - physiology
- Hepatic Artery - surgery
- Humans -
- Intraoperative Period -
- Liver Diseases - surgery
- Liver Transplantation - adverse effects
- Liver Transplantation - methods
- Liver Transplantation - mortality
- Male -
- Middle Aged -
- Prospective Studies -
- Regional Blood Flow -
- Thrombosis - mortality
- Thrombosis - prevention & control
- Find related publications in this database (Keywords)
- Arterial complication
- Algorithm
- Liver transplantation
- Hepatic artery thrombosis