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World Journal of Surgery

, Volume 42, Issue 10, pp 3357–3363 | Cite as

Re-transplantation for Hepatic Artery Thrombosis: A National Perspective

  • Shu Kwun Lui
  • Catherine R. Garcia
  • Xiaonan Mei
  • Roberto Gedaly
Original Scientific Report

Abstract

Background

Hepatic artery thrombosis (HAT) is a major complication after liver transplantation that commonly requires re-transplantation.

Methods

We queried the UNOS dataset for all patients transplanted between 1995 and 2015 for HAT.

Results

We identified 623 patients who underwent re-transplantation for HAT with a mean age of 51.25 + 10.4 years. The mean BMI was 26.72 kg/m2, and mean MELD score was 19.62 + 9.09. There was a higher proportion of male patients, with higher prevalence of pre-transplant portal vein thrombosis (7.4 vs. 5.4%, p = 0.04), lower incidence of hepatitis C virus infection (29.5 vs. 35.8%, p = 0.002), and shorter waiting time (61 vs. 111 days, p = 0.001) in the HAT group compared to those re-transplanted for other indications. The perioperative 90-day mortality was lower in patients re-transplanted for HAT (16 vs. 20%, p = 0.02). Patients undergoing re-transplantation for HAT had 13% decreased graft survival and 13% increased long-term survival. After case–control matched analysis, graft survival and patient survival were significantly better in the HAT group. Late re-transplantation (>30 days) for HAT was linked to decreased graft and patient survival when compared to those undergoing early re-transplantation (within 30 days).

Conclusions

Improved outcomes were seen in patients undergoing re-transplantation for HAT compared to patients who underwent re-transplantation for other indications. Those re-transplanted late after HAT (>30 days) were associated with worse outcomes when compared to early re-transplantation.

Abbreviations

HAT

Hepatic artery thrombosis

LT

Liver transplantation

BMI

Body mass index

Notes

Authors’ contribution

SKL, CRG, XM, and RG designed research/study. SKL, CRG, XM, and RG performed research/study. XM collected data. SKL, XM, and RG analyzed data. SKL, CRG, XM, and RG wrote the paper.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Shu Kwun Lui
    • 1
  • Catherine R. Garcia
    • 1
  • Xiaonan Mei
    • 1
  • Roberto Gedaly
    • 1
  1. 1.Department of Surgery - Transplant Division, College of MedicineUniversity of KentuckyLexingtonUSA

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