Hepatic artery thrombosis occurs when a

blood clot A thrombus ( thrombi) is a solid or semisolid aggregate from constituents of the blood (platelets, fibrin, red blood cells, white blood cells) within the circulatory system during life. A blood clot is the final product of the blood coagulatio ...

forms in the artery that provides blood flow to the liver. Hepatic artery thrombosis may occur as a complication after

liver transplantation Liver transplantation or hepatic transplantation is the replacement of a diseased liver with the healthy liver from another person (allograft). Liver transplantation is a treatment option for end-stage liver disease and acute liver failure, al ...

, and represents the most common complication of liver transplantation.

Smoking tobacco Tobacco smoking is the practice of burning tobacco and ingesting the resulting smoke. The smoke may be inhaled, as is done with cigarettes, or released from the mouth, as is generally done with pipes and cigars. The practice is believed to hav ...

increases the risk of hepatic artery thrombosis in people who have undergone liver transplantation. Hepatic artery thrombosis may cause severe elevations in serum aminotransferases,

alanine transaminase Alanine aminotransferase (ALT or ALAT), formerly alanine transaminase (ALT), and even earlier referred to as serum glutamate-pyruvate transaminase (GPT) or serum glutamic-pyruvic transaminase (SGPT), is a transaminase enzyme () that was first c ...

(ALT) and

aspartate transaminase Aspartate transaminase (AST) or aspartate aminotransferase, also known as AspAT/ASAT/AAT or (serum) glutamic oxaloacetic transaminase (GOT, SGOT), is a pyridoxal phosphate (PLP)-dependent transaminase enzyme () that was first described by Arthur ...

(AST). Often the AST is greater than the ALT. Hepatic artery thrombosis is usually diagnosed with ultrasound with doppler, although it may be diagnosed using

computed tomography A computed tomography scan (CT scan), formerly called computed axial tomography scan (CAT scan), is a medical imaging technique used to obtain detailed internal images of the body. The personnel that perform CT scans are called radiographers or ...

(CT) or

magnetic resonance imaging Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and ...

(MRI). The treatment for recently developed or acute hepatic artery thrombosis include

anticoagulant medication An anticoagulant, commonly known as a blood thinner, is a chemical substance that prevents or reduces the coagulation of blood, prolonging the clotting time. Some occur naturally in blood-eating animals, such as leeches and mosquitoes, which he ...

fibrinolytic therapy Thrombolysis, also called fibrinolytic therapy, is the breakdown (lysis) of blood clots formed in blood vessels, using medication. It is used in ST elevation myocardial infarction, stroke, and in cases of severe venous thromboembolism (massive pu ...

to break up the blood clot, or surgical revascularization. If acute hepatic artery thrombosis occurs after liver transplantation, then retransplantation with a new liver may be necessary.

Signs and symptoms

Hepatic artery thrombosis can cause severe elevations in serum liver enzymes, AST and ALT. Often the AST is greater than the ALT. When it occurs after liver transplantation, it usually develops within 4 months after surgery.

Diagnosis

Hepatic artery thrombosis is diagnosed with ultrasound with doppler, which shows a lack of blood flow through the hepatic artery. Hepatic artery thrombosis may also be diagnosed using CT or MR imaging, which would show evidence of a blood clot within the hepatic artery.

Treatment

Treatment for acute hepatic artery thrombosis include anticoagulant medications, fibrinolysis therapies to break up the blood clot, or surgical revascularization. If acute hepatic artery thrombosis occurs after liver transplantation, then retransplantation with a new liver may be necessary. However, chronic hepatic artery thrombosis may not require therapy, as the gradual development of additional blood vessels (collateral circulation) may be adequate for the metabolic needs of the liver.

Prognosis

The development of hepatic artery thrombosis soon after liver transplantation is associated with higher risk of death (mortality) and transplanted liver failure (graft loss).

Epidemiology

Hepatic artery thrombosis is the most common complication that occurs after liver transplantation. Hepatic artery thrombosis may also occur after other surgeries. Hepatic artery thrombosis and primary non-function are the two most common reason that a transplanted liver fails to work (graft failure). Among people who receive liver transplants, smoking tobacco increases the risk of hepatic artery thrombosis.

References

{{Vascular diseases Hepatology Vascular diseases Diseases of arteries, arterioles and capillaries