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.

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