Behera Arunanshu, Kaman Lileswar, Dahiya Divya, Tandup Cherring, Kalra Naveen
Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Department of Radio-diagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
J Clin Exp Hepatol. 2022 Mar-Apr;12(2):654-657. doi: 10.1016/j.jceh.2021.09.004. Epub 2021 Sep 22.
Hepatic arterial vasospasm can be a potential vascular complication after liver transplantation and can manifest as hepatic artery thrombosis. Due to the scarcity of literature on this pathology, its incidence, mechanism, relevance, diagnosis, and prognosis remain to be investigated. Our index case, a 64-year-old man with decompensated alcohol-related cirrhosis, underwent a cadaveric orthotopic liver transplant and was having a normal postoperative course. On postoperative day 12, liver enzymes were elevated, and Doppler ultrasound performed showed hepatic arterial occlusion. In view of hepatic artery thrombosis digital subtraction angiography (DSA) was done, which showed a string bead appearance of graft hepatic artery, with no thrombosis or stenosis of hepatic artery anastomosis. It was managed by oral administration of vasodilator, as well as intra-arterial administration of vasodilators through DSA catheter tip placed in the hepatic artery. He responded well to the management and was discharged on postoperative day 24 with normal liver enzymes.
肝动脉痉挛可能是肝移植术后潜在的血管并发症，可表现为肝动脉血栓形成。由于关于这种病理情况的文献稀缺，其发病率、机制、相关性、诊断和预后仍有待研究。我们的索引病例是一名64岁患有失代偿期酒精性肝硬化的男性，接受了尸体原位肝移植，术后过程正常。术后第12天，肝酶升高，多普勒超声检查显示肝动脉闭塞。鉴于肝动脉血栓形成，进行了数字减影血管造影（DSA），结果显示移植肝动脉呈串珠样表现，肝动脉吻合口无血栓形成或狭窄。通过口服血管扩张剂以及经置于肝动脉的DSA导管尖端进行动脉内血管扩张剂给药来进行处理。他对治疗反应良好，术后第24天肝酶正常时出院。
