Singhal Ashish, Mukherjee Indraneil, Stokes Kenneth, Wright Harlan I, Sebastian Anthony, Kohli Vivek
Nazih Zuhdi Transplant Institute, INTEGRIS Baptist Medical Center, Oklahoma City, Oklahoma, USA.
Vasc Endovascular Surg. 2010 Feb;44(2):134-8. doi: 10.1177/1538574409348353. Epub 2009 Dec 23.
Hepatic artery thrombosis remains one of the major causes of graft failure and mortality in liver transplant recipients. Urgent re-transplantation has been considered as mainstay therapy; however, even with re-transplantation mortality of more than 50% has been reported by many series. Early detection on Doppler ultrasonography and subsequent revascularization in asymptomatic patients can avoid graft loss. Endovascular therapy including intra-arterial thrombolysis, percutaneous transluminal angioplasty, and stent placement have shown encouraging results in recent years; nevertheless, their use remains controversial due to potential risk of bleeding. We present a case of early hepatic artery thrombosis following liver transplantation treated successfully with continuous transcatheter intra-arterial thrombolysis using tissue plasminogen activator (t-PA).
肝动脉血栓形成仍然是肝移植受者移植物失败和死亡的主要原因之一。紧急再次移植一直被视为主要治疗方法；然而，许多系列报道显示，即使进行再次移植，死亡率仍超过50%。在无症状患者中通过多普勒超声早期检测并随后进行血管重建可避免移植物丢失。近年来，包括动脉内溶栓、经皮腔内血管成形术和支架置入在内的血管内治疗已显示出令人鼓舞的结果；然而，由于存在出血的潜在风险，其应用仍存在争议。我们报告一例肝移植术后早期肝动脉血栓形成的病例，该病例通过使用组织型纤溶酶原激活剂（t-PA）进行持续经导管动脉内溶栓成功治疗。
