Hepatic artery complications after liver transplantation

We present the arterial complications arising from 100 orthotopic liver transplants (OLT) carried out in 87 consecutive patients. Mean patient age was 42.5 +/- 12.8 years (7-63). There was a predominance of male patients (67%). The most common indications were hepatic cirrhosis (53%) and severe acute hepatitis insufficiency (14%). The donor liver presented 29 arterial malformations, mainly a left hepatic artery arising from the left gastric artery, either as a single or associated anomaly. Only six arterial complications appeared in 4 of the 87 patients. Of these six, four corresponded to arterial thrombosis, and the remaining two to arterial stenosis and a ruptured mycotic aortic aneurysm. Two of the 4 patients had a double arterial complication (one had arterial thrombosis in 2 of the 3 grafts, and the other presented arterial thrombosis and aortic rupture). No arterial complications were related to arterial anomalies in the donor liver. Three of the 4 patients died from the complication. The 1-year actuarial survival rate in our series is 77.5%. In conclusion, arterial complications are infrequent in our series (6%) but do carry a high mortality rate (75%).