Recurrent thrombosis of liver transplant artery: diagnosis and staged minimally invasive treatment
https://doi.org/10.16931/1995-5464.2022-2-108-114
Abstract
The paper presents a clinical study of a 53-year-old patient who underwent liver transplantation complicated by proper hepatic artery thrombosis. No clinical or laboratory signs of the complication were observed. The disruption of arterial blood supply to the transplant was established on day six following surgery by means of routine Doppler ultrasound. Following successful selective endovascular thrombus aspiration and balloon dilation, the arterial blood flow was restored. However, one day later, the thrombosis recurred. Hepatic revascularization was achieved through thrombus re-aspiration and the proper hepatic artery stenting. In the subsequent postoperative period, no complications were observed. The paper analyzes possible causes of thrombosis and recurrent thrombosis, as well as reviewing modern literature.
About the Authors
S. E. Grigorev
Irkutsk State Medical University
Sergey E. Grigoryev – Cand. of Sci. (Med.), Surgeon at the Department of Portal Hypertension, Irkutsk Regional Clinical Hospital; Assoc. Prof. at the Department of Advanced Surgery
1, Krasnogo Vosstaniya str., Irkutsk, 664003
A. V. Novozhilov
Irkutsk State Medical University
Alexander V. Novozhilov – Cand. of Sci. (Med.), Head of Department of Portal Hypertension, Irkutsk Regional Clinical Hospital; Assoc. Prof. at the Department of Advanced Surgery
1, Krasnogo Vosstaniya str., Irkutsk, 664003
E. G. Grygoryev
Irkutsk State Medical University; Irkutsk Scientific Center of Surgery and Traumatology
Russian Federation
Russian Federation
Evgeny G. Grigoryev – Doct. of Sci. (Med.), Professor, Corresponding Member of RAS, Research Advisor; Head of Department of Advanced Surgery
1, Krasnogo Vosstaniya str., Irkutsk, 664003
1, Bortsov Revolyutsii str., Irkutsk, 664003
References
1. Gautier S.V., Voskanov M.A., Monakhov A.R., Semash K.O. The role of endovascular and endobiliary methods in the treatment of post-liver transplant complications. Russian Journal of Transplantology and Artifcial Organs. 2020; 22 (4): 140–148. https://doi.org/10.15825/1995-1191-2020-4-140-148 (In Russian)
2. Korobka V.L., Kostrykin M.Yu., Kotov O.V., Dabliz R.O., Pak E.S. The management of the hepatic artery thrombosis after liver transplantation. Transplantologiya. The Russian Journal of Transplantation. 2020; 12 (4): 295–300. https://doi.org/10.23873/2074-0506-2020-12-4-295-300 (In Russian)
3. Zhuravel S.V., Chugunov A.O., Salienko A.A., Donova L.V. Liver transplantation complicated by acute portal vein thrombosis. Ann. Crit. Care. 2009; 3: 70–72. (In Russian)
4. Repina E.V., Makarkina M.A., Nagovitsina R.Y., Dunaevskaya S.S., Deulina V.V. Complex ultrasound of complications after orthotopic liver transplantation. Modern Problems of Science and Education. 2019; 6: 210. https://scienceeducation.ru/ru/article/view?id=29366 (In Russian)
5. Zhu H.K., Zhuang L., Chen C.Z., Ye Z.D., Wang Z.Y., Zhang W., Cao G.H., Zheng S.S. Safety and efficacy of an integrated endovascular treatment strategy for early hepatic artery occlusion after liver transplantation. Hepatobiliary Pancreat. Dis. Int. 2020; 19 (6): 524–531. https://doi.org/10.1016/j.hbpd.2020.09.014
6. Moiseenko A.V., Polikarpov A.A., Tarazov P.G., Tileubergenov I.I., Maystrenko D.N., Granov D.A. Endovascular interventions in correction of arterial complications after orthotopic liver transplantation. Diagnostic and Interventional Radiology. 2021; 15 (1): 51–58. https://doi.org/10.25512/DIR.2021.15.1.05 (In Russian)
7. Yanaga K., Lebeau G., Marsh J.W., Gordon R.D., Makowka L., Tzakis A.G., Todo S., Stieber A.C., Iwatsuki S., Starzl T.E. Hepatic artery reconstruction for hepatic artery thrombosis after orthotopic liver transplantation. Arch. Surg. 1990; 125 (5): 628–631. https://doi.org/10.1001/archsurg.1990.01410170076016
8. Sanada Y., Katano T., Hirata Y., Yamada N., Okada N., Ihara Y., Ogaki K., Otomo S., Imai T., Ushijima K., Mizuta K. Interventional radiology treatment for vascular and biliary complications following pediatric living donor liver transplantation – a retrospective study. Transpl. Int. 2018; 31 (11): 1216–1222. https://doi.org/10.1111/tri.13285
9. Novruzbekov M.S., Olisov O.D. Vascular complications after orthotopic liver transplantation. Transplantologiya. The Russian Journal of Transplantation. 2017; 9 (1): 35–50. https://doi.org/10.23873/2074-0506-2017-9-1-35-50 (In Russian)
10. Zhuravel S.V., Andreytseva O.I., Donova L.V., Dzhagraev K.R., Chzhao A.V. Prophylaxis end treatment of vascular complications after liver transplantation. Transplantologiya. The Russian Journal of Transplantation. 2012; 1–2: 33–37. (In Russian)
11. Braun H.J., Grab J.D., Dodge J.L., Syed S.M., Roll G.R., Schwab M.P., Liu I.H., Glencer A.C., Freise C.E., Roberts J.P., Ascher N.L. Retransplantation after living donor liver transplantation: data from the adult to adult living donor liver transplantation study. Transplantation. 2021; 105 (6): 1297–1302. https://doi.org/10.1097/TP.0000000000003361
12. Gunsar F., Rolando N., Pastacaldi S., Patch D., Raimondo M.L., Davidson B., Rolles K., Burroughs A.K. Late hepatic artery thrombosis after orthotopic liver transplantation. Liver Transpl. 2003; 9 (6): 605–611. https://doi.org/10.1053/jlts.2003.50057
13. Oberkofler C.E., Reese T., Raptis D.A., Kuemmerli C., de Rougemont O., De Oliveira M.L., Schlegel A., Dutkowski P., Clavien P.A., Petrowsky H. Hepatic artery occlusion in liver transplantation: What counts more, the type of reconstruction or the severity of the recipient’s disease? Liver Transpl. 2018; 24 (6): 790–802. https://doi.org/10.1002/lt.25044
14. Uchida Y., Sakamoto S., Egawa H., Ogawa K., Ogura Y., Taira K., Kasahara M., Uryuhara K., Takada Y., Kamiyama Y., Tanaka K., Uemoto S. The impact of meticulous management for hepatic artery thrombosis on long-term outcome after pediatric living donor liver transplantation. Clin. Transplant. 2009; 23 (3): 392–399. https://doi.org/10.1111/j.1399-0012.2008.00924.x
15. Duffy J.P., Hong J.C., Farmer D.G., Ghobrial R.M., Yersiz H., Hiatt J.R., Busuttil R.W. Vascular complications of orthotopic liver transplantation: experience in more than 4,200 patients. J. Am. Coll. Surg. 2009; 208 (5): 896–905. https://doi.org/10.1016/j.jamcollsurg.2008.12.032
16. Segel M.C., Zajko A.B., Bowen A., Bron K.M., Skolnick M.L., Penkrot R.J., Starzl T.E. Hepatic artery thrombosis after liver transplantation: radiologic evaluation. AJR Am. J. Roentgenol. 1986; 146 (1): 137–141. https://doi.org/10.2214/ajr.146.1.137
17. Miraglia R., Maruzzelli L., Caruso S., Marrone G., Cortis K., Spada M., Luca A. Minimally invasive endovascular and biliary treatments of children with acute hepatic artery thrombosis following liver transplantation. Pediatr. Radiol. 2014; 44 (1): 94–102. https://doi.org/10.1007/s00247-013-2772-4
Supplementary files
Review
For citations:
Grigorev S.E., Novozhilov A.V., Grygoryev E.G. Recurrent thrombosis of liver transplant artery: diagnosis and staged minimally invasive treatment. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2022;27(2):108-114. (In Russ.) https://doi.org/10.16931/1995-5464.2022-2-108-114
Views:
583
Email this article 