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Updated: Aug 18, 2026
Re-Arterialized Rat Partial Liver Transplantation with an in vivo Vessel-Oriented 70% Hepatectomy
Published on: April 8, 2018
Angiographically determined arteriopathy in liver graft dysfunction and survival
J Devlin1, A C Page, J O'Grady
1Institute of Liver Studies, Kings College School of Medicine and Dentistry, London, UK.
Insights
Hepatic angiography is crucial for identifying arterial lesions in liver transplant grafts. Early detection of arteriopathy significantly impacts graft survival, guiding timely interventions for better outcomes.
Area of Science:
- Transplantation Medicine
- Vascular Surgery
- Diagnostic Imaging
Background:
- Liver transplant graft survival is significantly influenced by vascular complications.
- Hepatic arterial complications, including thrombosis and stenosis, are critical determinants of graft outcome.
- Accurate diagnosis of arterial lesions is essential for effective management.
Purpose of the Study:
- To evaluate the role of hepatic angiography in detecting arterial lesions in liver transplant recipients.
- To assess the impact of major vessel and microvascular arterial lesions on graft survival.
- To compare the diagnostic accuracy of angiography with Doppler ultrasonography.
Main Methods:
- Retrospective analysis of 50 liver transplant patients.
- Inclusion of three clinical groups: early graft dysfunction, suspected thrombosis/stenosis, and chronic rejection.
- Utilized flush and selective hepatic angiography for lesion assessment.
Main Results:
- Angiography identified arterial lesions in acute cellular rejection, correlating with graft loss.
- Hepatic arterial thrombosis was associated with poor graft survival (10%) compared to stenosis (100%).
- Arteriopathy was detected in 65% of chronic rejection cases, predicting graft loss, while Doppler ultrasonography had limited findings.
Conclusions:
- Hepatic angiography is superior to Doppler ultrasonography in diagnosing hepatic arterial complications.
- Early identification of arteriopathy via angiography is vital for predicting and managing graft survival.
- Angiographic findings of arteriopathy correlate strongly with graft loss in liver transplant recipients.
Abstract:
We evaluated the contribution of flush and selective hepatic angiography in defining the extent and pattern of major vessel and microvascular arterial lesions and their significance in graft survival. The 50 consecutive patients investigated comprised three clinical groups: Group A (n = 18) were patients with severe graft dysfunction within the first seven days post-transplantation. In this group six of 18 angiograms demonstrated intrahepatic attenuation of the arterial tree suggestive of acute cellular rejection and four of these grafts were lost, compared to a 78% graft survival in the non-arteriopathic group. Group B (n = 16) comprised patients with clinically suspected hepatic arterial thrombosis or stenosis, these diagnoses were confirmed in all patients compared to only 10 positive findings with doppler ultrasonography. Graft survival was only 10% in those patients with artery thrombosis as compared to 100% in those with arterial anastomotic stenoses. Group C patients (n = 16) had histologically confirmed chronic allograft rejection and in ten of them (65%) evidence of arteriopathy was demonstrated despite histological evidence of arteriopathy being present in only 19% of patients. All patients in this group with arteriopathic changes lost their grafts with the exception of one successfully treated with FK506. In two other patients reversibility of chronic rejection was observed, neither of whom had evidence of an arteriopathy.
