Open AccessLiver transplantation and spontaneous neovascularization after arterial thrombosis: “the neovascularized liver”
Author(s) -
Panaro Fabrizio,
Gallix Benoit,
Bouyabrine Hassan,
Ramos Jeanne,
Addeo Pietro,
Testa Giuliano,
Carabalona Jean Pierre,
Pageaux George,
Domergue Jacques,
Navarro Francis
Publication year - 2011
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/j.1432-2277.2011.01293.x
Subject(s) - medicine , liver transplantation , thrombosis , artery , common hepatic artery , anastomosis , transplantation , cardiology , surgery , radiology
Summary The only arterial pathway available after liver transplantation is the hepatic artery. Therefore, hepatic artery thrombosis can result in graft loss necessitating re‐transplantation. Herein, we present evidence of neovascularization at long‐term follow‐up in a series of transplant patients with hepatic artery thrombosis. We termed this phenomenon “neovascularized liver”. Hepatic artery thrombosis was noted in 30/407 cases (7.37%), and occurred early in 13 patients (43.3%) and late (>30 days) in 17 (56.7%) patients. At the time of this study, 11 (36.7%) patients had a neovascularized liver. Those patients with neovascularized liver and normal liver function were closely followed. Of these patients, 10 (91%) showed evidence of neovascularized liver by imaging, and an echo‐Doppler arterial signal was recorded in all patients. The mean interval between the diagnosis of hepatic artery thrombosis and neovascularized liver was 4.1 months (range of 3–5.5 months). Liver histology showed an arterial structure in 4 (36.4%) patients. Four factors were associated with development of neovascularized liver: late hepatic artery thrombosis, early hepatic artery stenosis, site of thrombosis, and Roux‐en‐Y anastomosis. The overall survival rate at 54 months was 90.9%. In conclusion, a late hepatic artery thrombosis may be quite uneventful and should not automatically lead to re‐transplantation.