[Diagnosis and management for early hepatic artery thrombosis after liver transplantation].

OBJECTIVE: To explore the diagnosis and management of early hepatic artery thrombosis (HAT) after liver transplantation. METHODS: Routine examination of Color Doppler Imagine (CDI) was used to detect hepatic artery flow after liver transplantation in 220 cases from April 2001 to November 2004. Suspected patients were further confirmed by immediate hepatic artery angiography, and continuous infusion of urokinase through hepatic artery with catheter was performed to the patients with HAT. RESULTS: HAT was identified in 6 patients (2.7%), occurring 5.5 days (2 - 19 days) after liver transplantation. Hepatic artery recanalization was obtained in 6 cases. One patient died from lung infection 2 months after liver transplantation. One patient underwent the second liver transplantation because of the recurrence of HAT 6 months after the first transplantation, but died from multiple system organ failure 2 months after the operation. The other 4 cases have been surviving well disease-freely. CONCLUSIONS: CDI is useful for the diagnosis of early HAT after liver transplantation. Contributes to recovery of the hepatic artery flow, continuous infusion of urokinase through hepatic artery with catheter may be the first choice of the therapy for early HAT.

Stage II surgical resection of hepatocellular carcinoma after TAE:a report of 38 cases.

AIM:To evaluate the curative effect of stageII surgical resection of hepatocellular carcinoma after TAE.METHODS:Thirty-eight patients with unresectable hepatocellular carcinoma were treated by transcatheter arterial embolization (TAE).When the sizes of tumors were markedly reduced after TAE, stage II surgical resections were performed.RESULTS:Before TAE, the diameters of tumors were 12.84cm & plusmn; 4.87cm (x & plusmn;s), but reduced to 5.12 cm& plusmn; 1.82cm (x& plusmn; s) after TAE (P < 0.001). Pathologic examination of the resected specimens revealed obvious necrosis in most cases. After surgery, 26 patients were alive, with the longest survival of 96 months, twelve died and 10 had tumor recurrence.CONCLUSION:Patients in moderate and advanced stages of hepatocellular carcinoma after TAE should be treated surgically, but the indication must be controlled strictly.