Vascular complications following liver transplantation: A literature review of advances in 2015

Table 4 Hepatic artery pseudoaneurysm highlights

Summary of the clinical characteristics about HAP
The reported incidence of HAP is ranging from 0.27% to 3% following OLT
In most cases, HAP is localized extra-hepatic and occurred in the early postoperative period around 1 mo post-OLT (69% within 20 d and 81% within 35 POD)
Clinical presentation varies from the asymptomatic state and incidental diagnosis to abdominal pain with fever and gastrointestinal bleeding (25% of cases, massive bleeding through the abdominal drain or acutely with hemorrhagic shock)
Risk factors include peritoneal infection, biliary leak, bilbo-digestive anastomosis and digestive leak
Diagnosis of HAP is confirmed by DUS (with lower performance), contrast-enhanced CT scan, magnetic resonance angiography or angiography
Treatment of HAP includes reoperation (urgent laparotomy for HA ligation: Mortality rate 60%; HAP excision and immediate revascularization with a cryopreserved arterial allograft: Mortality rate 28%) or interventional radiology (HA embolization with a coil or HAP exclusion with a covered stent)
HAP has a worse prognosis with an overall mortality of more than 50% (ranging from 53% to 100%)
Early recognition of HAP in the population at high risk is mandatory and allows for a successful therapeutic outcome in 100% of cases

DUS: Doppler ultrasound; HA: Hepatic artery; HAP: Hepatic artery pseudoaneurysm; OLT: Orthotopic liver transplantation; CT: Computed tomography.