Urgent revascularization of a liver allograft with a saphenous vein interposition graft between the hepatic artery and the recipient splenic artery after late hepatic artery thrombosis

Abstract

Hepatic artery thrombosis (HAT) after liver transplantation is a severe complication which may lead to graft infarction and subsequent graft loss. It complicates 2–12% of adult liver transplantations (1, 2) and subsequently leads to retransplantation in 50–75% of patients (3). Fortunately, innovations in Doppler ultrasonography and digital angiography technologies have provided an accurate and rapid method for detecting HAT before ischemic damage of the allograft (4). Revascularization procedures that can be performed once the diagnosis of HAT has been confirmed include thrombectomy alone, intrahepatic arterial thrombolysis with thrombolytic agents, creation of a new anastomosis between a more proximal part of the recipient artery and a more distal part of the donor hepatic artery, and introduction of an interposition graft (3). Early diagnosis is a prerequisite for these revascularization strategies.