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BACKGROUND: Early hepatic artery thrombosis(e HAT) has been recognized as an important cause of graft loss and mortality. However, the incidence, etiology and outcome are not clear, especially for children. The present study was to investigate the formation of collateral artery flow after irreversible e HAT and its impact on patient’s prognosis. METHODS: We analyzed e HAT after liver transplantation in children from October 2006 to April 2015 in our center, illustrated the formation of collateral hepatic artery flow after irreversible e HAT and explored the diagnosis, complications, treatment and prognosis. The basic and follow-up ultrasonographic images were also compared. RESULTS: Of the 330 pediatric liver recipients, 22(6.67%) developed e HAT within 1 month. Revascularization attempts including surgical thrombectomy, interventional radiology and conservational treatment(thrombolysis) were successful in 5 patients. Among the 17 patients who had irreversible e HAT, follow-up ultrasonography revealed that collateral artery flow was developed as early as 2 weeks after e HAT. Liver abscess and bile duct complication occurred secondary to e HAT in variable time. CONCLUSIONS: Collateral arterial formation is a compensatory adaptation to e HAT to supply blood to liver grafts. However, the severe bile duct damage secondary to e HAT is irreversible and retransplantation is unavoidable.
BACKGROUND: Early hepatic artery thrombosis (e HAT) has been recognized as an important cause of graft loss and mortality. However, the incidence, etiology and outcome are not clear, especially for children. The present study was to investigate the formation of collateral artery flow after irreversible e HAT and its impact on patient’s prognosis. METHODS: We analyzed e HAT after liver transplantation in children from October 2006 to April 2015 in our center, illustrated the formation of collateral hepatic artery flow after irreversible e HAT and explored the diagnosis, complications, treatment and prognosis. The basic and follow-up ultrasonographic images also also. RESULTS: Of the 330 pediatric liver recipients, 22 (6.67%) developed e HAT within 1 month. Revascularization attempts include surgical thrombectomy, interventional radiology and conservational treatment (thrombolysis) were successful in 5 patients. Among the 17 patients who had irreversible e HAT, follow-up ultrason ography revealed that collateral artery flow was developed as early as 2 weeks after e HAT. Liver abscess and bile duct complication occurred secondary to e HAT in variable time. CONCLUSIONS: Collateral arterial formation is a compensatory adaptation to e HAT to supply blood to liver grafts However, the severe bile duct damage secondary to e HAT is irreversible and retransplantation is unavoidable.