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[Acute hepatic artery thrombosis in pediatric liver transplantation: surgical thrombectomy and in situ fibrinolysis].
- Source :
-
Annales de chirurgie [Ann Chir] 1992; Vol. 46 (7), pp. 605-9. - Publication Year :
- 1992
-
Abstract
- In pediatric liver transplantation, hepatic artery thrombosis usually leads to graft loss, early due to hepatic necrosis when it occurs during the first week following the transplant procedure, or later due to biliary complications. Liver retransplantation is the usual attitude. However, urgent surgical hepatic arterial thrombectomy to restore the blood flow can be successful when early diagnosis is made with Doppler ultrasound examination and angiography. Four hepatic arterial thrombectomies were performed as an emergency with additional intra-hepatic arterial fibrinolytic treatment, in three children, 1.5, 3 and 5.5 years of age. Mean duration between the first signs of hepatic artery thrombosis and thrombectomy was 16 hours. None of the children had an urgent liver retransplantation. A complete success was obtained in one case, with normal liver function tests and patent hepatic artery on the Doppler ultrasound examination at the present time. In the two other cases, hepatic artery thrombosis recurred, in spite of repeated thrombectomy in one case; following this attempt complications of hepatic artery thrombosis occurred in the two patients: ischemic necrosis of the left lobe (1 case), biliary leak (1 case) and stenosis of the common bile duct (2 cases). A complete success in one case and a partial success in the two others lead us to advocate urgent thrombectomy and in situ fibrinolytic treatment when early diagnosis of hepatic artery thrombosis is made.
- Subjects :
- Acute Disease
Angiography
Aortography
Child, Preschool
Female
Hepatic Artery physiopathology
Humans
Infant
Male
Thrombosis diagnostic imaging
Thrombosis drug therapy
Thrombosis etiology
Fibrinolysis
Hepatic Artery surgery
Liver Transplantation adverse effects
Thrombectomy methods
Thrombosis surgery
Urokinase-Type Plasminogen Activator therapeutic use
Subjects
Details
- Language :
- French
- ISSN :
- 0003-3944
- Volume :
- 46
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Annales de chirurgie
- Publication Type :
- Academic Journal
- Accession number :
- 1456691