Concurrent Hepatic Artery and Portal Vein Thrombosis after Orthotopic Liver Transplantation with Preserved Allografts
In contrast to early HAT, late HAT has an insidious clinical presentation. Nevertheless, biliary and vascular reconstructions in this late setting are unlikely to improve outcome. Patent portal flow makes an important contribution to the viability of liver in case of late HAT while the allograft rec...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Case Reports in Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2014/384295 |
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| author | Arshad Khan P. Park Jose Oberholzer Ivo Tzvetanov Raquel Garcia Roca Ron C. Gaba Enrico Benedetti Hoonbae Jeon |
| author_facet | Arshad Khan P. Park Jose Oberholzer Ivo Tzvetanov Raquel Garcia Roca Ron C. Gaba Enrico Benedetti Hoonbae Jeon |
| author_sort | Arshad Khan |
| collection | DOAJ |
| description | In contrast to early HAT, late HAT has an insidious clinical presentation. Nevertheless, biliary and vascular reconstructions in this late setting are unlikely to improve outcome. Patent portal flow makes an important contribution to the viability of liver in case of late HAT while the allograft reconstitutes intrahepatic arterial flow through neovascularization. Concurrent HAT with PVT without immediate graft necrosis is extremely rare, and allograft and patient survival are seemingly impossible without retransplantation. In fact, hepatopetal arterial and portal venous neovascularization are known albeit obscure phenomena that can preserve posttransplant
hepatic function under the extenuating circumstances of complete interruption of blood flow to the graft. We describe two such cases that developed combined HAT and PVT more than six months after OLT with perfect preservation of graft function. The survival of allografts in our cases was due to extensive hepatopetal arterial and portal venous collateralization. Simultaneous HAT and PVT after OLT are rare events and almost uniformly fatal, if they occur early. Due to paucity of such cases, however, underlying mechanisms and etiology remain elusive, and despite radiological diagnosis of these complications, there is no way to predict these events in the wake of stable graft function. |
| format | Article |
| id | doaj-art-3200f187246c4a478246004cf014879b |
| institution | Kabale University |
| issn | 2090-6943 2090-6951 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Transplantation |
| spelling | doaj-art-3200f187246c4a478246004cf014879b2025-02-03T01:06:47ZengWileyCase Reports in Transplantation2090-69432090-69512014-01-01201410.1155/2014/384295384295Concurrent Hepatic Artery and Portal Vein Thrombosis after Orthotopic Liver Transplantation with Preserved AllograftsArshad Khan0P. Park1Jose Oberholzer2Ivo Tzvetanov3Raquel Garcia Roca4Ron C. Gaba5Enrico Benedetti6Hoonbae Jeon7Department of Surgery, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USADepartment of Surgery, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USADepartment of Surgery, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USADepartment of Surgery, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USADepartment of Surgery, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USADepartment of Radiology, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USADepartment of Surgery, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USADepartment of Surgery, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USAIn contrast to early HAT, late HAT has an insidious clinical presentation. Nevertheless, biliary and vascular reconstructions in this late setting are unlikely to improve outcome. Patent portal flow makes an important contribution to the viability of liver in case of late HAT while the allograft reconstitutes intrahepatic arterial flow through neovascularization. Concurrent HAT with PVT without immediate graft necrosis is extremely rare, and allograft and patient survival are seemingly impossible without retransplantation. In fact, hepatopetal arterial and portal venous neovascularization are known albeit obscure phenomena that can preserve posttransplant hepatic function under the extenuating circumstances of complete interruption of blood flow to the graft. We describe two such cases that developed combined HAT and PVT more than six months after OLT with perfect preservation of graft function. The survival of allografts in our cases was due to extensive hepatopetal arterial and portal venous collateralization. Simultaneous HAT and PVT after OLT are rare events and almost uniformly fatal, if they occur early. Due to paucity of such cases, however, underlying mechanisms and etiology remain elusive, and despite radiological diagnosis of these complications, there is no way to predict these events in the wake of stable graft function.http://dx.doi.org/10.1155/2014/384295 |
| spellingShingle | Arshad Khan P. Park Jose Oberholzer Ivo Tzvetanov Raquel Garcia Roca Ron C. Gaba Enrico Benedetti Hoonbae Jeon Concurrent Hepatic Artery and Portal Vein Thrombosis after Orthotopic Liver Transplantation with Preserved Allografts Case Reports in Transplantation |
| title | Concurrent Hepatic Artery and Portal Vein Thrombosis after Orthotopic Liver Transplantation with Preserved Allografts |
| title_full | Concurrent Hepatic Artery and Portal Vein Thrombosis after Orthotopic Liver Transplantation with Preserved Allografts |
| title_fullStr | Concurrent Hepatic Artery and Portal Vein Thrombosis after Orthotopic Liver Transplantation with Preserved Allografts |
| title_full_unstemmed | Concurrent Hepatic Artery and Portal Vein Thrombosis after Orthotopic Liver Transplantation with Preserved Allografts |
| title_short | Concurrent Hepatic Artery and Portal Vein Thrombosis after Orthotopic Liver Transplantation with Preserved Allografts |
| title_sort | concurrent hepatic artery and portal vein thrombosis after orthotopic liver transplantation with preserved allografts |
| url | http://dx.doi.org/10.1155/2014/384295 |
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