Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

18 July 2014 : Original article  

Preservation of Arterial Vascularization After Hepatic Artery Pseudoaneurysm Following Orthotopic Liver Transplantation: Long-Term Results

Enrico VolpinBCDE, Patrick PessauxBCDEF, Alain SauvanetABCDEF, Annie SibertBCDF, Reza KianmaneshABDEF, François DurandABCDEF, Jacques BelghitiABCDEF, Daniele SommacaleABCDEF

DOI: 10.12659/AOT.890473

Ann Transplant 2014; 19:346-352


BACKGROUND: Hepatic artery pseudoaneurysm (HAP) is a serious complication of orthotopic liver transplantation (OLT). The aim of this study was to determine risk factors for HAP and the best management of this complication.

MATERIAL AND METHODS: Between 1990 and 2005, 787 OLT were performed at our center. Patients who developed HAP were identified from our prospective database and risk factors of HAP were identified. Management of HAP was analyzed retrospectively.

RESULTS: There were 16 OLT (2.5%) complicated by HAP [median delay =13 days; range: 4–100 days]. Presentation was massive bleeding with shock (n=13), pain (n=2), or transient gastrointestinal bleeding (n=1). Bacteriological culture of HAP wall or ascites fluid was positive in 13 (81%) patients. Bilio-enteric anastomosis and biliary leak were identified as risk factors for HAP (p=0.011 and 0.002, respectively), whereas indication for OLT, surgical technique (full-graft OLT versus other techniques), and re-LT were not. Mortality rate after HAP rupture was 53% (7/13), but no deaths occurred in the 3 patients treated before rupture. Treatment included: excision and immediate revascularization [n=7; early mortality =2 (28%), long-term graft survival =4 (57%)], hepatic artery ligation [n=5; early mortality =3 (80%);, long-term graft survival with good liver function =0], and endovascular treatment [n=2; early mortality =0, long-term survival with good liver function =2].

CONCLUSIONS: HAP post-OLT carries a high mortality rate when detected after rupture, but recognition before rupture usually allows a successful outcome. Reconstruction with bilio-enteric anastomosis and postoperative biliary leak increase the risk for HAP. In these settings, CT with contrast injection should be performed to screen for HAP when there is any suspicion. Graft revascularization should be attempted whenever possible.

Keywords: hepatic artery pseudoaneurysm , cohort study, Liver Transplantation

Add Comment 0 Comments

1232 30

In Press

10 Nov 2023 : Original article  

Effects of Preservation of Donor Liver Gastroduodenal Artery on Post-Transplant Biliary Complications in 18...

Ann Transplant In Press; DOI:  

07 Nov 2023 : Original article  

Allogeneic Hematopoietic Stem Cell Transplantation Can Improve Prognosis of Extramedullary Infiltration Pos...

Ann Transplant In Press; DOI:  

06 Nov 2023 : Original article  

Clinical Outcomes of Administration of Rituximab for Desensitization in Liver Transplant Patients with Pref...

Ann Transplant In Press; DOI:  

06 Nov 2023 : Original article  

Short-Term Monitoring of Graft Regeneration in Partial Liver Transplantation Recipients

Ann Transplant In Press; DOI:  

Most Viewed Current Articles

24 Aug 2021 : Review article  

Normothermic Machine Perfusion (NMP) of the Liver – Current Status and Future Perspectives

DOI :10.12659/AOT.931664

Ann Transplant 2021; 26:e931664

26 Jan 2022 : Review article  

Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models

DOI :10.12659/AOT.934924

Ann Transplant 2022; 27:e934924

29 Dec 2021 : Original article  

Efficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...

DOI :10.12659/AOT.933588

Ann Transplant 2021; 26:e933588

15 Mar 2022 : Case report  

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358