Recipient celiac trunk stenosis is a significant risk factor for early hepatic artery thrombosis after liver transplantation

Background: Hepatic artery thrombosis (HAT) is a rare but severe complication after liver transplantation (LT). The aim was to study risk factors of HAT, notably a recipient celiac trunk stenosis and a variant anatomy of the recipient hepatic artery, in our single center experience. Methods: Between 1997 and 2013, a total of 709 LT in 618 patients were performed at our center. Early (<30 days) HAT (EHAT) occurred in 18, late HAT (LHAT) in 12 patients. Patients with EHAT and LHAT were compared to a randomized control group of 100 patients without HAT. Recipient celiac trunk stenosis was assessed on pre-LT imaging by two independent radiologists. Univariate analysis by Fishers exact test and a multivariate logistic regression were used the EHAT group, a descriptive analysis in the LHAT group. Results: In univariate analysis, stenosis of the recipient celiac trunk, presence of accessory hepatic arteries, retransplantation, use of an aortic conduit and the amount of transfused FFP were significantly associated with the development of EHAT. Upon multivariate regression, only a stenosis of the celiac trunk (p=0.001) and retransplantation (p=0.002) were significantly associated with EHAT. LHAT seemed to be associated with the use of an aortic conduit and retransplantation. Conclusion: This is the first study to identify a stenosis of the recipient celiac trunk as a significant risk factor for the development of early hepatic artery thrombosis after LT. Patients should be systematically screened.