Interventional Treatment for Hepatic Artery Thrombosis after Liver Transplantation

To evaluate short-term and long-term effectiveness of interventional treatment for hepatic artery thrombosis (HAT).

From March 2003 to October 2015, 34 patients (32 male and 2 female; mean age, 45 y; range 7-64 y) with HAT were identified 0-21d (mean 6.5 d ± 6.0) after liver transplantation and underwent interventional treatments. Technical success, clinical success, complications, hepatic artery patency, and survival time were assessed.

All 34 patients underwent urokinase thrombolytic treatment. The mean dosage of urokinase was 1,250,000 U ± 1,000,000 (range, 350,000-9,000,000 U). Thrombolysis treatment required 5-120 h (mean 50 h ± 31) for completion. In 21 patients, stents were also implanted during thrombolytic treatment. In 3 patients with splenic artery steal syndrome, proximal splenic artery embolization was performed during thrombolytic treatment. The technical and clinical success rate was 91% (31/34), with treatment failure in 3 children. Hemorrhage was observed in 11 cases. Local necrotic foci in the transplanted liver were found on CT in 5 patients. Complications associated with the interventional procedures occurred in 2 patients. Patency rates of the hepatic artery at 1 y, 2 y, 3 y, and 5 y were 96%, 93%, 83%, and 83%. Overall survival rate at 1 y, 2 y, 3 y, and 5 y were 82%, 73%, 57%, and 57%.

Interventional treatment can achieve satisfactory short-term and long-term effectiveness for adult HAT.