Hepatic artery thrombosis after orthotopic liver transplantation: A reviewof nonsurgical causes

Hepatic artery thrombosis (HAT) is one of the principal causes of morbidity and graft loss following liver transplantation. There are several risk fac tors for the development of HAT; technical aspects of the arterial anastomo sis are important particularly for early thrombosis, but the improvement of surgical technique has lessened this problem. Apart from technical causes, other risk factors include a variety of conditions such as low donor/recip ient age ratio, immunologic factors, cloning abnormalities, tobacco use, an d infections. In particular, cytomegalovirus (CMV) infection of endothelial cells has been recently suggested as an infective cause of HAT, as it is k nown to be followed by a rapid procoagulant response. Thus, latent CMV in a n allograft may become activated and promote or contribute to vascular thro mbosis. This review evaluates these aspects, focusing on data relating CMV infection or viremia to HAT following liver transplantation.