Hepatic artery thrombosis linked to graft loss after paediatric liver transplantation

The HEPATIC study (NCT05818644) retrospectively examined HAT outcomes and management in 415 children (median age 1.7 years) identified across 33 centres in 21 countries. The primary outcomes reported were graft loss and mortality at one year after HAT diagnosis. HAT occurred within seven days of transplantation in 68% of patients.

Graft loss occurred in 43% within one month of HAT diagnosis and 54% within one year; mortality was 12% and 19%, respectively. One-year graft loss was higher after early HAT (≤7 days) than after later HAT (>7 days), at 57% versus 47%. Management varied: surgical revascularization was reported in 167 patients, while conservative management and endovascular therapy were also used; 66 patients with early HAT were listed for retransplantation.

These retrospective, multicentre data describe the substantial burden of HAT and an association between earlier onset and graft loss. They do not establish which management strategy is most effective, and treatment comparisons may be affected by patient selection. The source is a research highlight citing the registry study published in The Lancet Child & Adolescent Health.