Arcuate ligament syndrome inducing hepatic artery thrombosis after liver transplantation

来源 :国际肝胆胰疾病杂志(英文版) | 被引量 : 0次 | 上传用户:oklizheng
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BACKGROUND:?Hepatic artery thrombosis (HAT) is a frequent complication following liver transplantation, but it is rarely caused by arcuate ligament compression of the celiac artery. This article mainly describes our experience in managing a patient with celiac artery stenosis and HAT after liver transplantation. METHODS:?A 44-year-old man with a 15-year history of hepatitis B was admitted to our hospital for hepatocellular carcinoma. Before the operation, he received trans-arterial chemoembolization once, and pretransplant MR angiography indicated a suspected stenosis at the initiation of the celiac artery, while color Doppler showed normal blood lfow in the arterial system. In this case, orthotopic liver transplantation was performed for radical cure of hepatocellular carcinoma. However, B-ultrasonography detected poor blood lfow in the intra- and extra-hepatic artery on the ifrst posttransplant day, and during exploratory laparotomy a thrombus was found in the hepatic artery. Thus, re-transplantation was conducted with a bypass between the graft hepatic artery and the recipient abdominal aorta with the donors splenic artery. RESULTS:?The patient made an uneventful recovery and color Doppler showed good blood lfow in the artery and portal system. Histology conifrmed extensive thrombosis in the left and right hepatic artery of the explanted graft, indicating HAT. CONCLUSIONS:?Although HAT caused by celiac trunk compression is rarely reported in liver transplantation, the diagnosis should be considered in patients with pretransplant hepatic artery stenosis on angiography and abnormal blood lfow on B-ultrasonography. Once HAT is formed, treatment such as thrombectomy or re-transplantation should be performed as early as possible.
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