RISK FACTORS ASSOCIATED WITH HEPATIC ARTERY THROMBOSIS: ANALYSIS OF 1050 LIVER TRANSPLANTS

Area of Science:

• Hepatology
• Transplantation Surgery
• Vascular Surgery

Background:

• Hepatic artery thrombosis (HAT) is a critical complication following liver transplantation, leading to graft loss and biliary issues.
• Risk factors for HAT encompass both technical aspects of arterial anastomosis and non-surgical patient-related factors.

Purpose of the Study:

• To identify and evaluate the independent risk factors associated with the development of hepatic artery thrombosis post-liver transplantation.

Main Methods:

• A retrospective, cross-sectional study involving 1050 liver transplant cases.
• Analysis of donor and recipient variables to determine associations with hepatic artery thrombosis.
• Statistical methods included univariate and multivariate analyses, and prevalence ratio testing for anastomosis techniques.

Main Results:

• Univariate analysis identified MELD score (p=0.04) and warm ischemia time (p=0.005) as significant risk factors.
• Multivariate analysis confirmed prolonged warm ischemia time (≥35 min) and MELD score (≥14.5) as independent predictors of HAT.
• Continuous suture technique for anastomosis was associated with a higher incidence of thrombosis compared to interrupted sutures.

Conclusions:

• Prolonged warm ischemia time, elevated MELD scores, and recipient age are independent risk factors for hepatic artery thrombosis in adult liver transplant recipients.
• The choice of arterial anastomosis suture technique (continuous vs. interrupted) influences thrombosis risk.
• Re-transplantation due to HAT correlates with increased recipient mortality, underscoring the importance of preventing primary thrombosis.