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Endovascular therapy for hepatic artery stenosis and thrombosis following liver transplantation

Saher S Sabri1, Wael E A Saad, Timothy M Schmitt

  • 1Division of Vascular and Interventional Radiology, Department of Radiology, University of Virginia Health System, Charlottesville, VA, USA.

Vascular and Endovascular Surgery
|May 17, 2011
PubMed

Insights

Endovascular management effectively treats hepatic artery stenosis (HAS) in liver transplants, achieving high patency and survival rates. However, it is not effective for treating hepatic artery thrombosis (HAT).

Area of Science:

  • Transplantation Surgery
  • Vascular Surgery
  • Interventional Radiology

Background:

  • Hepatic artery stenosis (HAS) and thrombosis (HAT) are serious complications following liver transplantation.
  • Vascular complications can significantly impact graft survival and patient outcomes.

Purpose of the Study:

  • To evaluate the efficacy of endovascular techniques for managing steno-occlusive disease in liver transplant recipients.
  • To assess the outcomes of endovascular treatment for HAS and HAT.

Main Methods:

  • Retrospective review of liver transplant patients diagnosed with HAS or HAT.
  • Treatment strategies included balloon angioplasty with stenting for HAS and catheter-directed thrombolysis for HAT.
  • Key outcome measures were primary, unassisted, and assisted patency rates, as well as graft survival.

Main Results:

  • The study included 31 patients (81% with HAS, 19% with HAT).
  • Endovascular procedures demonstrated a 91% technical success rate for HAS, with an 11% major complication rate.
  • Primary-assisted patency and graft survival at 12 months were 81% and 72%, respectively.
  • Successful thrombolysis for HAT was achieved in only one patient.

Conclusions:

  • Endovascular management, including angioplasty and stenting, is an effective treatment for hepatic artery stenosis in liver transplant recipients.
  • Catheter-directed thrombolysis is largely ineffective for treating hepatic artery thrombosis post-liver transplant.
Abstract

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