Статья

Liver transplantation and spontaneous neovascularization after arterial thrombosis: “the neovascularized liver”

Fabrizio PanaroDepartment of General and Liver Transplant Surgery, University of Montpellier, Hôpital Saint Eloi, Montpellier-Cedex 5, France. [email protected]B. Gallix Department of Abdominal Imaging, University of Montpellier, Hôpital Saint Eloi, Montpellier‐Cedex 5, FranceHassan BouyabrineDepartment of General and Liver Transplant Surgery, University of Montpellier, Hôpital Saint Eloi, Montpellier-Cedex 5, FranceJosé RamosDepartment of Pathology and Laboratory Medicine, University of Montpellier, Hôpital Gui de Chauliac, Montpellier-Cedex 5, FrancePietro Addeo University of Chicago, Department of Surgery, Division of Transplant Surgery, Chicago, IL, USAGiuliano Testa University of Chicago, Department of Surgery, Division of Transplant Surgery, Chicago, IL, USAJean Pierre CarabalonaDepartment of General and Liver Transplant Surgery, University of Montpellier, Hôpital Saint Eloi, Montpellier-Cedex 5, FranceGeorge Philippe PageauxDepartment of Hepatology University of Montpellier Hôpital Saint Eloi Montpellier‐Cedex 5 FranceJ DomergueDepartment of General and Liver Transplant Surgery, University of Montpellier, Hôpital Saint Eloi, Montpellier-Cedex 5, FranceFrançis NavarroDepartment of General and Liver Transplant Surgery, University of Montpellier, Hôpital Saint Eloi, Montpellier-Cedex 5, France

2011en

ABI

Аннотация

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.

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Идентификаторы

DOI: 10.1111/j.1432-2277.2011.01293.x

Цитирования и источники

Цитирований: 2Использованных источников: 0

Показатели — AkademScholar