Conflicts of Interest The authors have declared no conflict of interest.
Liver transplantation and spontaneous neovascularization after arterial thrombosis: “the neovascularized liver”
Article first published online: 11 JUL 2011
© 2011 The Authors. Transplant International © 2011 European Society for Organ Transplantation
Volume 24, Issue 9, pages 949–957, September 2011
How to Cite
Panaro, F., Gallix, B., Bouyabrine, H., Ramos, J., Addeo, P., Testa, G., Carabalona, J. P., Pageaux, G., Domergue, J. and Navarro, F. (2011), Liver transplantation and spontaneous neovascularization after arterial thrombosis: “the neovascularized liver”. Transplant International, 24: 949–957. doi: 10.1111/j.1432-2277.2011.01293.x
- Issue published online: 28 JUL 2011
- Article first published online: 11 JUL 2011
- Received: 14 March 2011 Revision requested: 10 April 2011 Accepted: 1 June 2011 Published online: 11 July 2011
- hepatic artery thrombosis;
- liver transplantation;
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.