Is hepatic artery thrombosis after liver transplantation really a surgical complication?

T HE COM PLICA nON of hepatic arterial thrombosis (HAT) leads to an [!lmost universally fatal outcome without retransplantation. 1•4 Although this problem occurs in both adults and children, its incidence is significantly higher in the pediatric population, where it remains one of the major causes of mortality and retransplantationY Some of the known causes of HAT after orthotopic liver transplantation (OLT) are purely technical. These include clamp traction on the recipient hepatic artery (HA), faulty placement of anastomotic sutures, and the inappropriate angulation of the donor HA or anastomotic site. 2•5 Certain non-technical factors have been reported to predispose to HAT after OL T.1.1,6 In this analysis, these factors were investigated in 13 patients who sustained HAT either during or after OL T and who underwent an attempt at secondary arterial reconstruction.