Collateral Development in Thrombosis of the Hepatic Artery After Transplantation

Bernardo, Carmen María García; García, Beatriz; Buil, Pilar Redondo; León, Alberto Miyar de; Diéguez, Luisa González; Rodrigo, Víctor; Arrillaga, Ignacio González-Pinto; Velasco, Lucía

doi:10.1016/j.transproceed.2016.07.047

Cited by 6 publications

(2 citation statements)

References 7 publications

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“…We suppose that imaging‐proven collateral transformation maintained the good liver function. García Bernardo et al described the development of collaterals after HAT in a series of 18 patients, where only 1 patient with diagnosed collaterals needed retransplantation . The superior survival of patients with HAT who develop collaterals was also reported by Viveiros et al The authors of this study found an overall survival rate after 5 years of >80% in HAT patients with collaterals compared with 60% in patients without collaterals.…”

Section: Discussionsupporting

confidence: 72%

Hepatic artery occlusion in liver transplantation: What counts more, the type of reconstruction or the severity of the recipient's disease?

Oberkofler¹,

Reese²,

Raptis³

et al. 2018

Liver Transpl

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Although the type of hepatic artery revascularization technique is known to have an impact on patency rates, independent perioperative risk factors on patient outcomes are poorly defined. All consecutive adult patients undergoing cadaveric liver transplantation (n = 361) from July 2007 to June 2016 in a single institution were analyzed. Primary outcomes were early (<30 days) hepatic artery occlusion and primary hepatic artery patency rate. A multivariate model was used to identify independent risk factors for occlusion and the need of arterial conduit, as well as their impact on graft and patient survival. Arterial revascularization without additional reconstruction (end-to-end arterial anastomosis [AA]) was performed in 77% (n = 279), arterial reconstruction (AR) in 15% (n = 53), and aortohepatic conduit (AHC) in 8% (n = 29) of patients. AHC had the highest mean intraoperative flow (275 mL/minute; P = 0.02) compared with AA (250 mL/minute) and AR (200 mL/minute; P = 0.02). There were 43 recipients (12%) who had an occlusive event with successful revascularization in 20 (47%) recipients. One-year primary patency rates of AA, AR, and AHC were 97%, 88%, and 74%, respectively. Aortic calcification had an impact on early occlusion. AR (odds ratio [OR], 3.68; 95% confidence interval [CI], 1.26-10.75; P = 0.02) and AHC (OR, 6.21; 95% CI, 2.02-18.87; P = 0.001) were independent risk factors for early occlusion. Dyslipidemia additionally independently contributed to early occlusion (OR, 2.74; 95% CI, 0.96-7.87; P = 0.06). The 1- and 5-year graft survival rates were 83% and 70% for AA, 75% and 69% for AR, and 59% and 50% for AHC (P = 0.004), respectively. In conclusion, arterial patency is primarily determined by the type of vascular reconstruction rather than patient or disease characteristics. The preoperative lipid status is an independent risk factor for early occlusion, whereas overall occlusion is only based on the performed vascular reconstruction, which is also associated with reduced graft and patient survival. Liver Transplantation 24 790-802 2018 AASLD.

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Section: Discussionsupporting

confidence: 72%

Hepatic artery occlusion in liver transplantation: What counts more, the type of reconstruction or the severity of the recipient's disease?

Oberkofler¹,

Reese²,

Raptis³

et al. 2018

Liver Transpl

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show abstract

“…Previous studies [22,23] have shown that a rich collateral arterial blood supply may develop after documented stent occlusion. In our study, three patients with occlusion on cross-sectional imaging had flow in the intrahepatic arteries on ultrasonography and low/normal RIs.…”

Section: Discussionmentioning

confidence: 98%

Treatment of Hepatic Artery Stenosis in Liver Transplant Patients Using Drug-Eluting versus Bare-Metal Stents

Naidu

Alzubaidi

Knuttinen

et al. 2021

JCM

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Hepatic artery stenosis after liver transplant is often treated with endovascular stent placement. Our institution has adopted use of drug-eluting stents, particularly in small-caliber arteries. We aimed to compare patency rates of drug-eluting stents vs. traditional bare-metal stents. This was a single-institution, retrospective study of liver transplant hepatic artery stenosis treated with stents. Primary patency was defined as time from stent placement to resistive index on Doppler ultrasonography (<0.5), hepatic artery thrombosis, or any intervention including surgery. Fifty-two patients were treated with stents (31 men; mean age, 57 years): 15, drug-eluting stents; 37, bare-metal stents. Mean arterial diameters were 4.1 mm and 5.1 mm, respectively. Technical success was 100% (52/52). At 6 months, 1, 2, and 3 years, primary patency for drug-eluting stents was 80%, 71%, 71%, and 71%; bare-metal stents: 76%, 65%, 53%, and 46% (p = 0.41). Primary patency for small-caliber arteries (3.5–4.5 mm) with drug-eluting stents was 93%, 75%, 75%, and 75%; bare-metal stents: 60%, 60%, 50%, and 38% (p = 0.19). Overall survival was 100%, 100%, 94%, and 91%. Graft survival was 100%, 98%, 96%, and 90%. Stenting for hepatic artery stenosis was safe and effective. While not statistically significant, patency improved with drug-eluting stents compared with bare-metal stents, especially in arteries < 4.5 mm in diameter. Drug-eluting stents can be considered for liver transplant hepatic artery stenosis, particularly in small-caliber arteries.

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Diagnostic accuracy of Doppler ultrasound for detecting hepatic artery stenosis after liver transplantation

et al. 2021

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Collateral Development in Thrombosis of the Hepatic Artery After Transplantation

Cited by 6 publications

References 7 publications

Hepatic artery occlusion in liver transplantation: What counts more, the type of reconstruction or the severity of the recipient's disease?

Hepatic artery occlusion in liver transplantation: What counts more, the type of reconstruction or the severity of the recipient's disease?

Treatment of Hepatic Artery Stenosis in Liver Transplant Patients Using Drug-Eluting versus Bare-Metal Stents

Diagnostic accuracy of Doppler ultrasound for detecting hepatic artery stenosis after liver transplantation

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