Hepatic artery thrombosis is a concerning complication of orthotopic liver transplantation, and it most often occurs early in the posttransplant period. However, on rare occasions it can occur at a time remote from transplant. We present a case of ischemic cholangiopathy complicated by stricture and anastomotic bile leak from chronic hepatic artery thrombosis that occurred 11 years after the transplant. The initial biliary stenting helped with the resolution of the leak but she was found to have stones, sludge and copious pus at the time of stent exchange. Hepatic arteriography demonstrated complete occlusion of the transplant hepatic artery with periportal collaterals reconstituting intrahepatic hepatic arterial branches. The patient was subsequently referred for repeat liver transplantation.
1Division of Gastroenterology Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
2Division of Interventional Radiology, Department of Radiology, Indiana University School of Medicine, Indianapolis, IN
ACG Case Rep J 2018;5:e75. doi:10.14309/crj.2018.75. Published online: October 24, 2018.
Correspondence: Raj Vuppalanchi, MBBS, Associate Professor of Medicine, Division of Gastroenterology Indiana University School of Medicine, 702 Rotary Circle, Suite 225, Indianapolis, IN 46202 (firstname.lastname@example.org).
SymbolCopyright: © 2018 Krajicek et al. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0.
Financial disclosure: None to report.
Informed consent was obtained for this case report.
Received April 23, 2018; Accepted August 6, 2018