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01-04-2009 | original article

Feasibility and Effectiveness of a New Algorithm in Preventing Hepatic Artery Thrombosis after Liver Transplantation

Authors: Sascha A. Müller, Bruno M. Schmied, Arianeb Mehrabi, Thilo Welsch, Peter Schemmer, Ulf Hinz, Jürgen Weitz, Jens Werner, Markus W. Büchler, Jan Schmidt

Published in: Journal of Gastrointestinal Surgery | Issue 4/2009

Abstract

Introduction

The incidence of hepatic artery thrombosis (HAT) after liver transplantation (LTx) is up to 9% in adult recipients.

Material and Methods

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.

Results

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.

Discussion

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.

Conclusion

Therefore, we have implemented the presented algorithm, which showed an acceptable HAT rate.

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Title: Feasibility and Effectiveness of a New Algorithm in Preventing Hepatic Artery Thrombosis after Liver Transplantation
Authors: Sascha A. Müller
Bruno M. Schmied
Arianeb Mehrabi
Thilo Welsch
Peter Schemmer
Ulf Hinz
Jürgen Weitz
Jens Werner
Markus W. Büchler
Jan Schmidt
Publication date: 01-04-2009
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 4/2009
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-008-0753-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Feasibility and Effectiveness of a New Algorithm in Preventing Hepatic Artery Thrombosis after Liver Transplantation

Abstract

Introduction

Material and Methods

Results

Discussion

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Material and Methods

Results

Discussion

Conclusion

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