Effect of hepatic artery thrombosis on the prognosis of controlled donation after circulatory death donor liver transplantation during early postoperative period in children

Objective Hepatic artery thrombosis(HAT) is one of serious complications after liver transplantation. This study was intended to explore the effect of HAT on survival rate of patients/grafts and biliary complications early after liver transplantation with controlled donation after circulatory death (CDCD) donors in children. Methods The clinical data of 236 children with CDCD donor liver transplantation (donor age <14 years) were retrospectively analyzed. Among them, 37 patients developed HAT early postoperatively. The survival rate of patients/grafts and the occurrence of biliary complications were compared between two groups. Results The median follow-up period was 23 months. For HAT (n=37) and non-HAT (n=199) group, the median follow-up period was 27 and 22 months respectively. The 1-year and 3-year survival rates of grafts were 88.2%, 88.2% and 93.2%, 92.4% respectively. And no inter-group statistical difference existed (P=0.373). The 1-year and 3-year graft survival rates were 73.9%, 73.9% and 91.8%, 90.5% respectively. And inter-group statistical difference existed (P<0.01). The incidence of biliary leakage and biliary stricture were 13.5% and 2% and 29.7% and 5.5% respectively. Inter-group statistical differences existed. In HAT group, there were liver failure (n=7, 18.9%) and death (n=3, 8.1%) after transplantation. Conclusions HAT is one of the serious complications after liver transplantation. An early onset of HAT increases the incidence of biliary complications and graft loss in children after CDCD donor liver transplantation. For patients with graft failure, liver re-transplantation may be performed at the right time. Key words: Children; Donor; Liver transplantation; Hepatic artery thrombosis; Biliary complication; Survival rate