Intra-arterial thrombolysis for early hepatic artery thrombosis after liver transplantation

Table 1 Demographic data of the recipients and details of operation

Recipients and details of operation
Period	September, 2011-December, 2016
Number of cases	2.7% (4 of 147 cases)
Gender	Male: 2; Female: 2
Age (yr)	50 (36-67)
History of TACE	1 case
History of epigastric operation	None
Original disease	HCC: 2; Liver cirrhosis (unknown cause): 1; Acute hepatic failure (unknown cause): 1
ABO-compatibility	Identical: 2; Compatible: 1; Incompatible: 1
Anastomotic site	Donor: Artery bifurcation of the CHA and the SA: 3; The trunk of CHA:1; Recipient: artery bifurcation of the CHA and the GDA: 3; The trunk of CHA: 1
Operative suture	7-0 prolene: 3; 8-0 prolene: 1
Multiple anastomoses	None

TACE: Trans-catheter arterial chemoembolization; HCC: Hepatocellular carcinoma; CHA: Common hepatic artery; SA: Splenic artery; GDA: Gastroduodenal artery.

Table 2 Details of patients’ diagnosis and treatment for early hepatic artery thrombosis

			Case 1	Case 2	Case 3	Case 4
Diagnostic time (POD)			8	14	2	3
Diagnostic method	Suspected		Doppler ultrasonography	Doppler ultrasonography	Doppler ultrasonography	Doppler ultrasonography
	Confirmed		Hepatic arterial angiography	Hepatic arterial angiography	Hepatic arterial angiography	Hepatic arterial angiography
Thrombolytic drugs	Temporarily	Drugs	Urokinase and Fibrinogenase	Alteplase	Alteplase	Alteplase
		Approach	Through catheter	Through catheter	Through catheter	Through catheter
	Continuously	Drugs	Alteplase	Alteplase	Alteplase	Alteplase
		Approach	Peripheral vein	Through catheter	Through catheter	Through catheter
Thrombolysis time (h)			14	26	8.5	15
Average ACT (s)			177.8	144.6	146.3	160.0
Complications related to intra-arterial thrombolysis			Local bleeding puncture site hematoma	None	Intraperitoneal hemorrhage	Intraperitoneal hemorrhage

POD: Postoperative day; ACT: Activated clotting time.