Risk Factors of Oh et al for Early and Late Hepatic Artery Thrombosis After Liver Transplantation

 

Analysis: univariate analysis followed by multivariate analysis with logistic regression.

 

Arterial thrombosis was defined as total disruption of the arterial blood supply to the allograft.

 

Classification	Thrombosis Onset
early	< 1 month post-transplant
late	>= 1 month post-transplant

 

Factors associated with early hepatic artery thrombosis:

(1) arterial anastomosis to an old conduit (using a donor iliac artery to link the aorta to the recipient's hepatic artery) in a patient requiring retransplantation

(2) ratio of recipient-to-donor body weight > 1.25

(3) biopsy proven rejection within 1 week after the transplant

(4) recipient CMV negative and donor CMV positive

 

Risk Factor	Odds Ratio	95% CI	p value
arterial anastomosis	7.33	1.028 – 52.26	0.047
body weight ratio	5.64	1.28 – 24. 9	0.02
rejection in 1 week	2.66	1.16 – 6.08	0.02
CMV status	2.81	1.16 – 6.84	0.02

after Table 2, page 770

 

Factors associated with late hepatic artery thrombosis:

(1) both recipient and donor CMV negative

(2) female donor liver to a male recipient

Risk Factor	Odds Ratio	95% CI	p value
CMV status	2.26	1.33 – 3.82	0.002
female donor, male recipient	1.97	1.19 – 3.24	0.008

after Table 4, page 770

 

where:

• In the implementation I assigned 1 point for each 2 points of the rounded odds ratio.

 

Interpretation:

• The more risk factors that are present, the greater the risk for thrombosis.

• Evaluation of risk factors can help optimally match donor livers with recipients to minimize the risk of thrombosis.

• Patients at risk for early thrombosis may benefit from heparin therapy during the first month after the transplant.

• Patients at risk for late thrombosis should be monitored more closely for hepatic artery blood flow and treated aggressively if worsening blood flow is detected.