Angiographic and interventional radiologic considerations in liver transplantation

Cardella, J F; Castańeda-Zúńiga, W R; Hunter, David W.; Young, Alison; Amplatz, K

doi:10.2214/ajr.146.1.143

Cited by 61 publications

(14 citation statements)

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“…HAS has occurred in 4% to 11% of liver transplant recipients in previous series, although the incidence has likely been underestimated because of a lack of monitoring 14, 15. The etiology of HAS is not exactly understood, but the surgical technique (ie, the faulty placement of anastomotic sutures and angulations at the anastomotic sites), small vessels, and extrinsic compression are possible causes 16. In one series, some degree of stenosis was found at the anastomotic sites in 70% of cases within 3 to 4 months of transplantation 7.…”

Section: Discussionmentioning

confidence: 99%

Association of hepatic artery stenosis and biliary strictures in liver transplant recipients

et al. 2011

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Biliary complications are important causes of morbidity and graft failure in patients after orthotopic liver transplantation. Nonanastomotic biliary strictures (NAS) are frequently the most challenging biliary complications. Hepatic artery stenosis (HAS) as a cause of biliary strictures has not been studied well systematically. We performed a retrospective cohort study of patients who underwent liver transplantation at our institution between 1995 and 2007 to determine the incidence of biliary strictures (nonanastomotic and anastomotic) with HAS. Forty patients were identified, and they were compared with 62 matched non-HAS controls. Overall, NAS and biliary anastomotic strictures were seen more frequently in patients with HAS (24/40 or 60%) versus control patients (6/62 or 9.67%, P < 0.000001). Cholangiographic evidence of NAS was seen in 10 of 40 study patients (25%) and in 1 of 62 control patients (2%, P < 0.0001), whereas evidence of biliary anastomotic strictures was seen in 14 of 40 study patients (35%) and in 5 of 62 control patients (8%, P ¼ 0.0006). The cold ischemia time was also found to be associated with the presence of NAS in patients with HAS (P ¼ 0.024). Patients with biliary strictures were generally managed successfully with endoscopic retrograde cholangiopancreatography balloon dilation/stenting, except for 4 NAS patients who had significant morbidity and mortality. In conclusion, the development of HAS, particularly with a prolonged cold ischemia time, may increase the NAS risk after liver transplantation. HAS is also associated with the development of biliary anastomotic strictures. Prospective studies of frequent arterial monitoring for the early detection of HAS and interventions to prevent biliary complications are needed.

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Section: Discussionmentioning

confidence: 99%

Association of hepatic artery stenosis and biliary strictures in liver transplant recipients

et al. 2011

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“…Contrast-enhanced CT can provide accurate information regarding the patency of the portal vein and its tributaries. Although portal vein thrombosis was once a relative contraindication to orthotopic liver transplantation [3][4][5], the use of increasingly sophisticated techniques to treat splanchnic venous thrombosis has eliminated this contraindication [6]. However, knowledge of the extent of the thrombosis is crucial for planning a successful portal vein reconstruction because a long segment thrombosis indicates the need to harvest iliac veins from the liver donors for portal vein reconstruction.…”

Section: Portal Vein Thrombosismentioning

confidence: 99%

Impact of double helical CT and three-dimensional CT arteriography on surgical planning for hepatic transplantation

et al. 1999

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“…Cholangiographic findings after liver transplantation and some of the pitfalls associated with the complications listed above have been reviewed in the recent literature [4]. The potential pitfall that we present here, however, has not been described.…”

Section: Discussionmentioning

confidence: 96%

Dilated periportal lymphatics mimicking an anastomotic bile leak after liver transplantation

Rabin

Abramson

Manzarbeitia

et al. 1991

Gastrointest Radiol

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Angiographic and interventional radiologic considerations in liver transplantation

Cited by 61 publications

References 0 publications

Association of hepatic artery stenosis and biliary strictures in liver transplant recipients

Association of hepatic artery stenosis and biliary strictures in liver transplant recipients

Impact of double helical CT and three-dimensional CT arteriography on surgical planning for hepatic transplantation

Dilated periportal lymphatics mimicking an anastomotic bile leak after liver transplantation

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