Stent placement in four patients with hepatic artery stenosis or thrombosis after liver transplantation

Hepatic artery stenosis and thrombosis represent dangerous complications of liver transplantation because the associated mortality and morbidity rates are high. In the past, repeat transplantation was considered the first-choice therapy; however, new surgical and interventional revascularization techniques have been suggested recently. Although extensive experience has been acquired with percutaneous transluminal angioplasty (PTA) and fibrinolysis techniques, only sporadic cases of stent placement in the hepatic artery of a transplanted liver have been reported, and no long-term results of this technique are available. In this study, seven stents (five Wallstents and two Palmaz stents) were positioned in four patients (two with stenoses and two with thromboses). Stent placement was performed in three cases after PTA and fibrinolysis, whereas primary stent placement was performed in the fourth. In all cases, technical success was achieved. During 18-25 months of follow-up, all stents proved patent and no patient required another transplantation. Although experience is still limited, the authors' experience indicates that placement of a stent in the hepatic artery in cases of stenosis or thrombosis yields good medium-term success, improving the results obtained by fibrinolysis and PTA and consequently enabling the graft to survive and avoiding the need for repeat transplantation.