Pre‐operative trans‐catheter arterial chemo‐embolization increases hepatic artery thrombosis after liver transplantation – a retrospective study. (12th September 2017)

• Record Type: Journal Article
• Authors: Gilbo, Nicholas; Van Praet, Laura; Jochmans, Ina; Sainz‐Barriga, Mauricio; Verslype, Chris; Maleux, Geert; Laleman, Wim; van der Merwe, Schalk; Cassiman, David; Nevens, Frederik; Monbaliu, Diethard; Pirenne, Jacques
• Is Part Of: Transplant international. Volume 31:Number 1(2018)
• Page Start: 71
• Page End: 81
• Publication Date: 2017-09-12
• Subjects: hepatic artery thrombosis -- liver transplantation -- trans‐catheter arterial chemo‐embolization; Transplantation of organs, tissues, etc -- Periodicals; 617.95405
• DOI: 10.1111/tri.13046
• Languages: English
• ISSNs: 0934-0874

Abstract

Summary: Little is known about nonsurgical risk factors for hepatic artery thrombosis (HAT) after liver transplantation (LT). We determined risk factors for HAT occurring within 90 days post‐LT and analysed the effect of HAT on graft and patient survival. Donor and recipient demographics, surgery‐related data and outcome in transplants complicated by thrombosis (HAT+) and their matched controls (HAT−) were compared. Risk factors were assessed by univariate logistic regression. Median (IQR) is given. A total of 25 HAT occurred among 1035 adult LT (1/1997–12/2014) and 50 controls were manually matched. Donor and recipient demographics were similar. Pre‐LT trans‐catheter arterial chemo‐embolization (TACE) was more frequent in HAT+ (HAT+ 20% vs. HAT− 4%, P = 0.037). HAT+ had longer implantation [HAT+ 88 min (76–108) vs. HAT− 77 min (66–93), P = 0.028] and surgery times [HAT+ 6.25 h (5.18–7.47) vs. HAT− 5.25 h (4.33–6.5), P = 0.001]. Early graft dysfunction and sepsis were more frequent in HAT+ and hospitalization longer. TACE had the greatest odds ratio in unadjusted analysis (OR: 6, 95% CI: 1.07–33.53, P = 0.03). All but seven grafts were lost after HAT (HAT+ 72% vs. HAT− 36%, P = 0.003); however, patient survival was unaffected (HAT+ 79.8% vs. HAT− 76%, P = 0.75). LT candidates undergoing TACE are at risk of developing HAT early after transplant.