Hepatic artery thrombosis occurs when a

blood clot A thrombus (plural thrombi), colloquially called a blood clot, is the final product of the blood coagulation step in hemostasis. There are two components to a thrombus: aggregated platelets and red blood cells that form a plug, and a mesh of c ...

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 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 transaminase (ALT) is a transaminase enzyme (). It is also called alanine aminotransferase (ALT or ALAT) and was formerly called serum glutamate-pyruvate transaminase or serum glutamic-pyruvic transaminase (SGPT) and was first character ...

(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 (CT) or

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

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

anticoagulant medication Anticoagulants, commonly known as blood thinners, are chemical substances that prevent or reduce coagulation of blood, prolonging the clotting time. Some of them occur naturally in blood-eating animals such as leeches and mosquitoes, where they ...

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 p ...

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