Frequency and Outcome of Hepatic Arterial Thrombosis in Recipients of Living Donor Liver Transplantation

J Coll Physicians Surg Pak. 2021 Aug;31(8):897-902. doi: 10.29271/jcpsp.2021.08.897.

Abstract

ABASTRACT Objective: To determine the frequency, risk factors, and management of hepatic arterial thrombosis (HAT) in recipients of living donor living transplantation.

Study design: Cohort study.

Place and duration of study: Department of Liver Transplant, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Sindh, Pakistan, from 1st January 2019 to 31st July 2020.

Methodology: Two hundred and forty living donor liver transplants (LDLT) recipients' data were evaluated. Frequencies of HAT were recorded, and various risk factors for the development of HAT were analysed by comparing HAT group (n = 12) and non-HAT group (n = 228). Management and outcome of HAT cases were also reviewed. Statistical analysis of this study was done with SPSS software version 21.

Results: Out of 240 patients, 212 (88.3%) were males. Overall mean age was 39.40 ± 12.14 years. Mean model for end-stage liver disease (MELD) score was 18.70 ± 4.98. Overall male to female ratio was 7.5:1. The common indication for LDLT in these patients was chronic liver disease secondary to hepatitis B and C virus infection in 85% of patients. Postoperative HAT incidence was found as 5%. Risk factor found statistically significant was intraoperative platelet transfusion.

Conclusion: HAT is a deadly complication and needs early detection to avoid graft loss. The risk factor documented in this study should be avoided, if possible. Moreover, prompt and quick action is necessary for re-vascularisation to avoid re-transplantation. Key Words: Living donor, Hepatic arterial thrombosis, Liver transplantation.

MeSH terms

  • Adult
  • Cohort Studies
  • End Stage Liver Disease* / surgery
  • Female
  • Hepatic Artery
  • Humans
  • Liver Diseases*
  • Liver Transplantation* / adverse effects
  • Living Donors
  • Male
  • Middle Aged
  • Pakistan / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Thrombosis* / epidemiology
  • Thrombosis* / etiology
  • Treatment Outcome