[Arterial complications after liver transplantation: early and late forms]

Arterial complications after liver transplantation (OLT) was related with high morbimortality rates, with variable consequences on patient and graft survival. 234 patients who underwent 270 liver transplantation between april of 1990 and december 1996 have been evaluated. Arterial complications were detected in 34 patients (12.5%), hepatic artery stenosis in 10 patients (29.4%), thrombosis in 24 (70.6%) and aneurysm in 2 (5.9%). It was considered early artery complications those diagnosed at the first month after OLT, and late complications the latest ones. Diagnosis was realized by Doppler sonography in all cases, and confirmed by celiac arteriography in those with Doppler abnormal findings. Clinical appearance of early artery complications were as acute liver failure (61.1%) or graft disfunction (38.8%). On the other hand, late complications were diagnosed incidentally in 46% of the patients due a programmed Doppler follow up. Actuarial survival at 24 months was higher in patients with late arterial complication (50 vs 30%; p < 0.01). Therapeutic measures applied were retransplantation, surgical artery reconstruction and angioplasty. Early complications required more frequently retransplantation or surgical reconstruction. Risk factors related with artery complications development were analyzed, but not significant differences between both types of arterial complications were found. It is concluded that programmed follow up by Doppler or arteriography is necessary to make an earlier diagnose and to detect silent arterial complications.