Hepatic Artery Vasospasm Masquerading as Hepatic Artery Thrombosis in a Case of Deceased Donor Liver Transplant

Abstract

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Hepatic artery vasospasm masquerading as early hepatic artery thrombosis in progressive familial intrahepatic cholestasis 3: a case report

“…Early vascular complications, such as HAT and HAS, can lead to allograft dysfunction and may necessitate retransplantation. While hepatic artery vasospasm has been documented in the literature [ 3 , 4 ], its pathophysiology remains unclear, and it is not easily distinguishable from HAT, anastomotic stricture, or stenosis in the early posttransplant period. Poiseuille’s law states that a reduction in vessel diameter results in increased resistance to flow [ 5 ].…”

“…All three patients displayed successful outcomes following revascularization [ 12 ]. Another case report described suspected HAT on day 11 posttransplant; this was diagnosed as hepatic artery vasospasm on diagnostic angiography and was successfully managed with transcatheter papaverine, urokinase, and intravenous nicorandil infusion [ 4 ].…”

“…HAT is the second major cause of allograft failure after primary nonfunction [ 1 ] and its reported incidence is 2.9% in adults and 8.3% in pediatric LT [ 2 ]. Although hepatic artery vasospasm has been reported in the literature [ 3 , 4 ], its pathophysiology is not known, nor it can be differentiated readily from HAT, anastomotic stricture, or stenosis early post-transplant. Early diagnosis with Doppler ultrasound (DUS) is critical as management varies according to the time of presentation.…”

A case of successful treatment of arterial and biliary complications in a patient after liver transplantation

“…Сосудистые осложнения в клинической трансплантологии считаются самыми сложными, именно поэтому на послеоперационном этапе крайне необходимы надлежащий контроль функционирования трансплантата и принятие оперативных действий в случае развития осложнений. Ключевой метод в диагностике как окклюзионного, так и неокклюзионного снижения кровотока -ультразвуковое исследование [3,13]. В случае выявления признаков ТПА необходима непрерывная инфузия антикоагулянтов (гепарин) с контролем времени приема тромбопластина каждые 6 часов.…”