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Updated: Feb 3, 2026

Surgical Procedures for a Rat Model of Partial Orthotopic Liver Transplantation with Hepatic Arterial Reconstruction
Published on: March 7, 2013
Primary Stent Placement for Hepatic Artery Stenosis After Liver Transplantation: Improving Primary Patency and
Ammar Sarwar1, Christine Chen1, Khalid Khwaja2
1Divisions of Vascular and Interventional Radiology, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Insights
Primary stenting for hepatic artery stenosis (HAS) in liver transplant patients shows excellent long-term patency. This approach resulted in a 90% primary patency rate at one year with minimal need for reintervention.
Area of Science:
- Hepatology
- Transplant Surgery
- Interventional Radiology
Background:
- Hepatic artery stenosis (HAS) is a common complication after liver transplantation.
- High reintervention rates are reported after primary stenting for HAS due to loss of primary patency.
Purpose of the Study:
- To evaluate the long-term outcomes of primary stenting for HAS in a large cohort of liver transplant recipients.
- To assess primary patency and reintervention rates following endovascular treatment of HAS.
Main Methods:
- Retrospective evaluation of liver transplant patients (2003-2017) for HAS.
- HAS defined as >50% stenosis on imaging.
- Primary stenting attempted in 30 patients; outcomes assessed annually.
Main Results:
- Technical success rate for primary stenting was 97%.
- Primary patency was 90% at 1 year and maintained throughout the follow-up period (median 41 months).
- Only 3 patients required reintervention; no major complications or hepatic artery thrombosis occurred.
Conclusions:
- Primary stenting for HAS in liver transplant recipients offers excellent long-term patency.
- This endovascular approach is associated with low reintervention rates and a favorable safety profile.
Abstract:
Recent studies have reported high rates of reintervention after primary stenting for hepatic artery stenosis (HAS) due to the loss of primary patency. The aims of this study were to evaluate the outcomes of primary stenting after HAS in a large cohort with longterm follow-up. After institutional review board approval, all patients undergoing liver transplantation between 2003 and 2017 at a single institution were evaluated for occurrence of hepatic artery complications. HAS occurred in 37/454 (8%) of patients. HAS was defined as >50% stenosis on computed tomography or digital subtraction angiography. Hepatic arterial patency and graft survival were evaluated at annual intervals. Primary patency was defined as the time from revascularization to imaging evidence of new HAS or reaching a censored event (retransplantation, death, loss to follow-up, or end of study period). Primary stenting was attempted in 30 patients (17 female, 57%; median age, 51 years; range, 24-68 years). Surgical repair of HAS prior to stenting was attempted in 5/30 (17%) patients. Endovascular treatment was performed within 1 week of the primary anastomosis in 5/30 (17%) of patients. Technical success was accomplished in 97% (29/30) of patients. Primary patency was 90% at 1 year and remained unchanged throughout the remaining follow-up period (median, 41 months; interquartile range [IQR], 25-86 months). Reintervention was required in 3 patients to maintain stent patency. The median time period between primary stenting and retreatment was 5.9 months (IQR, 4.4-11.1 months). There were no major complications, and no patient developed hepatic arterial thrombosis or required listing for retransplantation or retransplantation during the follow-up period. In conclusion, primary stenting for HAS has excellent longterm primary patency and low reintervention rates.
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