Korean J Transplant.  2022 Nov;36(Supple 1):S241. 10.4285/ATW2022.F-3813.

Intra-arterial thrombolysis for early hepatic artery thrombosis following liver transplantation: a case report

• Amankyeldi Y
• Radnaabazar M
• Byambaragchaa M
• Chogsom M
• Batdelger A

• KMID: 2535458
• DOI: http://doi.org/10.4285/ATW2022.F-3813

Abstract

Background
Hepatic artery thrombosis is a rare complication but should be detected at an early time. Early hepatic artery thrombosis is the major cause of graft failure and mortality following liver transplantation. At this time, the following methods can be used including retransplantation, revascularization, intra-arterial thrombolysis (TPA) treatment, and also observation.
Methods
On the first day after the operation, hepatic artery thrombosis was detected using US Doppler, and revascularization surgery was performed urgently using an RGEA vessel. However, due to the patient’s arterial damage, revascularization surgery failed. Therefore, in collaboration with the angiography department, we performed TPA (alteplase) treatment on the second day after the liver transplantation.
Results
At present, one case of hepatic artery thrombosis occurred out of a total of 60 liver transplants, and intra-arterial thrombolytic infusion treatment was performed. One year after surgery, biliary stricture occurred and ERCP-stenting was per-formed. He is currently being monitored for the third year after the operation.
Conclusions
Early hepatic arterial thrombosis is one of the most serious complications after liver transplantation, and it is important to detect and treat it at an early stage. Although the intra-arterial infusion of TPA was successful in this case, it is not the best option. It is believed that there is a risk of complications of the biliary tract after surgery.