Outcome Analysis of Antiplatelet Therapy With Aspirin in Liver Transplantation

Outcome Analysis of antiplatelet therapy with Aspirin in Liver Transplantation

BACKGROUND Arterial complications after liver transplantation (LT) are still one of the most serious complications, which might result in liver necrosis, abscess formation, ischemic cholangiopathy, and eventually graft loss. The sequel of these adverse events has a negative impact on graft and patient survival and remains a life-threatening complication with a high mortality and retransplantation rate. Therefore, an uncompromised inflow of the hepatic artery is crucial to avoid any occlusion after LT.

In the literature, the incidence of hepatic artery thrombosis ranges between 2.5 and 10%. So far, the possibility of preventing hepatic artery thrombosis through specific pharmacological prophylaxis with antiplatelet agents (Aspirin) has been poorly investigated, which may be in part due to the impaired coagulative state at the time of transplantation and the early postoperative period. On the other hand, platelets, the chief effectors of vascular homeostasis, have been identified as important players in the pathogenesis of both acute and chronic liver diseases in animal models.

In the experimental setting inhibition of platelet activation was able to reduce immune-mediated necro-inflammatory liver disease and consecutively hepatocellular carcinoma development. Therefore, antiplatelet therapy may not only have a preventive effect on hepatic artery patency but also on tumor recurrence.

So far and to the best of our knowledge, no study investigated the effect of antiplatelet therapy on hepatic arterial patency, tumor recurrence and graft survival after primary liver transplantation.