Impact of very advanced donor age on hepatic artery thrombosis after liver transplantation

Matteo Cescon, Matteo Zanello, Gian Luca Grazi, Alessandro Cucchetti, Matteo Ravaioli, Giorgio Ercolani, Massimo Del Gaudio, Augusto Lauro, Maria Cristina Morelli, Antonio Daniele Pinna

Research output: Contribution to journalArticle

Abstract

Background.: The impact of advanced donor age on hepatic artery thrombosis (HAT) after liver transplantation (LT) is controversial. Methods.: We analyzed the incidence of and risk factors for HAT in LT with donors aged 70 years or older. Eighty patients were transplanted between 1998 and 2002 (group A) and 132 between 2003 and 2008 (group B). Results.: In the more recent approach to hepatic artery (HA) reconstruction, the donor HA was systematically preferred to the Carrel patch/celiac trunk, the reconstruction of donor accessory right HA on the donor gastroduodenal artery significantly increased, and the use of interposition grafts was minimized. Group B showed higher Model for End-stage Liver Disease score, lower ischemia time, and lower use of the folding technique/mesenteric conduits. There were 10 cases of HAT (4.7%): 8 (10%) in group A and 2 (1.5%) in group B (P=0.007). Early HAT occurred in 7 (8.8%) patients in group A and in 2 (1.5%) in group B (P=0.02). Group A (P=0.01), anatomical variations of HA (P=0.005), and the use of interposition grafts (P=0.004) were all factors independently affecting HAT. Conclusions.: A low incidence of late HAT was observed in single-center LTs with very old donors. Early HAT decreased over time to largely acceptable rates because of more appropriate technical management.

Original languageEnglish
Pages (from-to)439-445
Number of pages7
JournalTransplantation
Volume92
Issue number4
DOIs
Publication statusPublished - Aug 27 2011

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Keywords

  • Hepatic artery thrombosis
  • Liver transplantation
  • Old donors

ASJC Scopus subject areas

  • Transplantation

Cite this

Cescon, M., Zanello, M., Grazi, G. L., Cucchetti, A., Ravaioli, M., Ercolani, G., Del Gaudio, M., Lauro, A., Morelli, M. C., & Pinna, A. D. (2011). Impact of very advanced donor age on hepatic artery thrombosis after liver transplantation. Transplantation, 92(4), 439-445. https://doi.org/10.1097/TP.0b013e3182252800