A case of asymptomatic process of hepatic artery thrombosis in the patients following orthotopic liver transplantation / 中华器官移植杂志

ABSTRACT

Objective　To investigate the possible causes for asymptomatic process of hepatic artery thrombosis in the patients following orthotopic liver transplantation (OLT). Methods　Hepatic functional tests, color Doppler ultrasonic observation, hepatic arteriographic examinations were done during the course of the development of the hepatic arteriothrombosis. All possible factors leading to the asymptomatic process were comprehensively analyzed. Results　At the 4th postoperative day, thrombosis started to form along the anastomosis line. At the 21st postoperative day, the artery became completely thromboses. During this course, serial liver biopsy revealed introhepatic cholestasis, hydropic degeneration of hepatocytes, atrophy of the biliary epithelium and fibrosis in the portal area. Serial monitoring of liver function gradually revealed normal with the exception of elevation of r-GT and ALP. At the 71st day after OLT, arteriography showed that hepatic artery remained completely occluded, while the collateral circulation and compensatory expansion of the portal vein were established. The patient didn't have any symptoms of arterial thrombosis. Conclusions　In this case, it was the collateral circulation and the compensation of the portal vein that made the allograft survive and helped to prevent the patient from retransplantation after hepatic artery thrombosis. Color Doppler ultrasonic examinations within 2 weeks following OLT were helpful to the early diagnosis of hepatic arteriothrombosis.