Diagnosis and management of arterial complications after liver transplantation / 中国普通外科杂志

ABSTRACT

Objective To explore the diagnosis and management of arterial complications after orthotopic liver transplantation (OLT). Methods The incidence, diagnosis and management of arterial complications of 180 OLT patients were analyzed retrospectively. Results A 5.0%(9/180)arterial complication rate was identified by selective angiography (8/9) and autopsy (1/9) in the 180 recipients, including 5 cases of hepatic artery thrombosis (HAT),3 cases of hepatic artery stenosis (HAS)and 1 celiac artery stenosis. Diagnostic sensitivity and specificity for arterial complications by color Doppler image (CDI) were 88.9% and 95.9% .The diagnostic sensitivity, specificity, positive and negative predictive value of intraoperative ultrasonography (IOUS) for arterial complications were 100%, 96.0%, 66.7% and 100%, respectively . Interventional procedures, revascularization, retransplantation and conservative treatment were used for 3,3,2 and 1 recipient respectively. Three patients were cured and 6 patients died. Conclusions CDI is a sensitive and specific way of monitoring arterial complications after OLT, and IOUS contributes to the early diagnosis. Revascularization and retransplantation are principal management for the patients with HAS or HAT. The conservative treatment might be effective for some asymptomatic patients, but interventional procedures may not obtain good results.