Pre-operative trans-catheter arterial chemo-embolization increases hepatic artery thrombosis after liver transplantation – a retrospective study

Little is known about nonsurgical risk factors for hepatic artery thrombosis (HAT) after liver transplantation (LT). We determined risk factors for HAT occurring within 90 days post-LT and analysed the effect of HAT on graft and patient survival. Donor and recipient demographics, surgery-related data and outcome in transplants complicated by thrombosis (HAT+) and their matched controls (HAT−) were compared. Risk factors were assessed by univariate logistic regression. Median (IQR) is given. A total of 25 HAT occurred among 1035 adult LT (1/1997–12/2014) and 50 controls were manually matched. Donor and recipient demographics were similar. Pre-LT trans-catheter arterial chemo-embolization (TACE) was more frequent in HAT+ (HAT+ 20% vs. HAT− 4%, P = 0.037). HAT+ had longer implantation [HAT+ 88 min (76–108) vs. HAT− 77 min (66–93), P = 0.028] and surgery times [HAT+ 6.25 h (5.18–7.47) vs. HAT− 5.25 h (4.33–6.5), P = 0.001]. Early graft dysfunction and sepsis were more frequent in HAT+ and hospitalization longer. TACE had the greatest odds ratio in unadjusted analysis (OR: 6, 95% CI: 1.07–33.53, P = 0.03). All but seven grafts were lost after HAT (HAT+ 72% vs. HAT− 36%, P = 0.003); however, patient survival was unaffected (HAT+ 79.8% vs. HAT− 76%, P = 0.75). LT candidates undergoing TACE are at risk of developing HAT early after transplant. © 2017 Steunstichting ESOT