Korean J Transplant.  2022 Nov;36(Supple 1):S94. 10.4285/ATW2022.F-2134.

Hepatic arterial thrombosis complication after living donor liver transplantation for hepatocellular carcinoma in Mongolia: report on first case

• Bayarsaikhan E

• KMID: 2535610
• DOI: http://doi.org/10.4285/ATW2022.F-2134

Abstract

Background
The liver transplantation (LT) has evolved last two years in National Cancer Center of Mongolia and LT has become one of the few curative treatment for patients with hepatocellular carcinoma (HCC) and liver cirrhosis.
Methods
Since 2017, We have successfully performed 60 cases in our hospital. One patient of them, had complication for hepatic arterial thrombosis at POD 5. It is happened only one case in 60 patients.
Results
The patient 52-year-old male, diagnosed HCC in liver with HBV+HDV related liver cirrhosis, gall bladder stone and esophageal varicose. Pre-procedure TACE (two times) and RFA (three times) due to HCC. Before operation patients laboratory and radiological experiments normal except liver failure. Surgery was successfully done and no complication during surgery. After surgery, condition of patient was stable. We check Doppler sonography every morning. Suddenly, hepatic arterial flow in Doppler sonography at POD 5, and we checked abdominal CT with contrast and angiography. We confirmed hepatic arterial thrombosis, then emergency reoperation for hepatic arterial re-anastomosis. But our second operation is failed, after operation hepatic arte-rial blood flow is not blowing. We use the local thrombolysis treatment by angiography.
Conclusions
In POD 11, arterial flowing normal, RI −0.6 in Doppler ultrasonography. Laboratory experiments are WBC 6.76*10 U/L, RBC 3.03*10 mmoL/L, PLT 59, HGB 9.5 g/dL, Ast 30 Alt 27, Crea 213 mmoL/L, bun 24.4 mmoL/L, total bilirubin 29 g/dL, INR 1.54, APTT 32.4 seconds, PT 18.9 seconds. we are infused among six unit blood divided three times. Now additionally patients have problem for pneumonia, we treating by antibiotics combination and mechanical ventilation by tracheostomy. Patients renal impairment was treated by CRRT, now diuresis are increased, enough for hour, creatinine and bun levels are decreased. Considering that case is our first case, based on only one case and we have no experience. This case result is not complete yet.