Continuous intraarterial thrombolysis for early hepatic artery thrombosis following liver transplantation: case report

Vasc Endovascular Surg. 2010 Feb;44(2):134-8. doi: 10.1177/1538574409348353. Epub 2009 Dec 23.

Abstract

Hepatic artery thrombosis remains one of the major causes of graft failure and mortality in liver transplant recipients. Urgent re-transplantation has been considered as mainstay therapy; however, even with re-transplantation mortality of more than 50% has been reported by many series. Early detection on Doppler ultrasonography and subsequent revascularization in asymptomatic patients can avoid graft loss. Endovascular therapy including intra-arterial thrombolysis, percutaneous transluminal angioplasty, and stent placement have shown encouraging results in recent years; nevertheless, their use remains controversial due to potential risk of bleeding. We present a case of early hepatic artery thrombosis following liver transplantation treated successfully with continuous transcatheter intra-arterial thrombolysis using tissue plasminogen activator (t-PA).

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Fibrinolytic Agents / administration & dosage*
  • Graft Survival
  • Hepatic Artery / diagnostic imaging
  • Hepatic Artery / surgery*
  • Humans
  • Infusions, Intra-Arterial
  • Liver Transplantation / adverse effects*
  • Male
  • Radiography
  • Thrombolytic Therapy*
  • Thrombosis / diagnosis
  • Thrombosis / drug therapy*
  • Thrombosis / etiology
  • Time Factors
  • Tissue Plasminogen Activator / administration & dosage*
  • Treatment Outcome
  • Ultrasonography, Doppler, Color

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator