Incidence of Donor Hepatic Artery Thrombosis in Liver Grafts Recognized During Organ Procurement and Backtable: A Rare but Treacherous Pitfall In Liver Transplantation.

Autor: Silva NA; Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil., Waisberg DR; Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil. Electronic address: daniel.waisberg@hc.fm.usp.br., Fernandes MR; Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil., Pinheiro RS; Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil., Santos JPC; Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil., Lima MRD; Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil., Alvarez PSE; Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil., Ernani L; Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil., Lins-Albuquerque MV; Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil., Nacif LS; Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil., Rocha-Santos V; Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil., Martino RB; Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil., Ducatti L; Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil., Arantes RM; Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil., Song AT; Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil., Lee AD; Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil., Haddad LB; Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil., Dala Riva DF; Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil., Silva AM; Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil., Galvão FH; Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil; Laboratory of Medical Investigation 37, University of Sao Paulo Medical School, Sao Paulo, Brazil., Andraus W; Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil; Laboratory of Medical Investigation 37, University of Sao Paulo Medical School, Sao Paulo, Brazil., Carneiro-D'Albuquerque LA; Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil; Laboratory of Medical Investigation 37, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2022 Jun; Vol. 54 (5), pp. 1345-1348. Date of Electronic Publication: 2022 May 20.
DOI: 10.1016/j.transproceed.2022.04.003
Abstrakt: Introduction: Donor hepatic artery thrombosis (dHAT) identified during liver procurement and backtable is a rare and little-reported event that can make liver transplants unfeasible.
Methods: This is a retrospective study of dHAT identified during liver grafts procurements or backtable procedures. All grafts were recovered from brain-dead donors. The demographic characteristics of the donors and the incidence of dHAT were analyzed. The data were also compared to a cohort of donors without dHAT.
Results: There was a total of 486 donors during the study period. The incidence of dHAT was 1.85% (n = 9). The diagnosis of dHAT was made during procurement in 5 cases (55.5%) and during the backtable in 4 (44.4%). Most donors were female (n = 5), with an average BMI of 28.14 ± 6.9 kg/m 2 , hypertensive (n = 5), and with stroke as cause of brain death (n = 8). The most prevalent site of dHAT was a left hepatic artery originating from the left gastric artery (n = 4). Of the 9 cases reported, 2 livers were used for transplantation, and 7 were discarded. Comparing those cases to a cohort of 260 donors without dHAT, we found a higher incidence of anatomic variations in the hepatic artery (P = .01) and of stroke as cause of brain death (P = .05).
Conclusion: The occurrence of dHAT before liver procurement is a rare event, however it may become a treacherous pitfall if the diagnosis is late. Grafts with anatomic variations recovered from women with brain death due to stroke and with past history of hypertension seem to be at a higher risk of presenting dHAT.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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