Vascular complications in adult liver transplant patients. Value of post-operative doppler ultrasound screening and the surgical management of hepatic arterial thrombosis

This retrospective study of 155 orthotopic liver transplanted patients (Dec 1984-May 1988) reveals an incidence of 5.8% of early hepatic artery thrombosis (1-13 days), 1.3% of late hepatic artery thrombosis (5 months-3 years), and 1.9% of late hepatic artery stenosis. Different underlying causes were found in the early and late complication groups. The sensitivity of early postoperative doppler ultrasound employed for screening of vascular complications was 100%, and its positive predictive value was 75%. Immediate thrombectomy and reconstruction of the arterial anastomosis was found to yield satisfactory long-term results as compared to retransplantation as a traditional management choice.