Transplant Hepatic Artery Stenosis: Endovascular Treatment and Complications

Molvar, Christopher; Ogilvie, R; Aggarwal, Deep; Borge, Marc A.

doi:10.1055/s-0039-1688420

Cited by 4 publications

(2 citation statements)

References 17 publications

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“…Literature reports effective treatment of stenosis of the HA in adult LT patients [ 31 ]. The decision between PTA alone or stenting should be based on features like morphology of the stenosis, tortuosity and kinking of the arteries, reserving PTA for shorter and focal stenoses [ 8 , 13 , 32 , 33 ]. A recent retrospective study [ 34 ] showed comparable outcomes of PTA with or without stenting, with slightly higher stenosis relapse after PTA alone.…”

Section: Discussionmentioning

confidence: 99%

Current Endovascular Management of Arterial Complications After Pediatric Liver Transplantation in a Tertiary Center

Marra,

Muglia,

Capodaglio

et al. 2023

Cardiovasc Intervent Radiol

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Purpose Pediatric liver transplant surgery is burdened by arterial complications whose endovascular treatment is not standardized. We report the outcomes of a cohort of pediatric recipients with hepatic artery complications treated by endoluminal procedures. Materials and Methods From December 2019 to December 2022, consecutive transplanted pediatric patients who underwent endovascular treatment of hepatic artery complications were reviewed. The analysis included: type of complication (occlusion, stenosis, pseudoaneurysm); onset (acute = < 15 days, subacute = 15–90 days, late = > 90 days); endovascular technique (angioplasty, stenting); complications and outcomes. Technical success was defined as the opacification of the hepatic artery at the final angiogram with < 50% residual stenosis and no pseudoaneurysms. Clinical success was defined by graft’s and patient’s survival. Results Seventeen patients (8 males; median age 33 months, IQR 9–103) underwent 21 hepatic arteriography procedures for predominantly acute or subacute occlusions (n = 7) or stenosis (n = 11) with concurrent pseudoaneurysms (n = 4). Primary and secondary technical success was achieved in 13/18 and 3/3 procedures, respectively, with overall technical success of 76%. Angioplasty alone was successful in 5/21 procedures; stent-retriever thrombectomy was performed in one occlusion with thrombosis; stenting was required in 9/17 (53%) patients. Clinical success was obtained in 14/17 (82%) patients with hepatic artery patency after a median of 367 days (IQR 114.5–500). Clinical failure occurred in 3 permanent occlusions, with 2 deaths and 1 re-transplantation. Procedure-related complications included minor events in 3/17 (18%) patients and 1/17 (6%) death. Conclusion In liver transplanted children with hepatic artery complications, endovascular treatment may provide clinical success, with stenting often required in acute and subacute conditions. Level of Evidence Level 4. Graphical Abstract

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Section: Discussionmentioning

confidence: 99%

Current Endovascular Management of Arterial Complications After Pediatric Liver Transplantation in a Tertiary Center

Marra,

Muglia,

Capodaglio

et al. 2023

Cardiovasc Intervent Radiol

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“…Angioplasty with stent placement can carry high risk for patients, 37 and revision of anastomosis can resolve or improve stenosis with controversial results. 13,38 In a study by Abbasoglu et al, out of 857 LTs, 41 patients had HAS, with 17 (41.4%, 17/41) being treated with primary reanastomosis. This subgroup had three deaths.…”

Section: Hepatic Artery Stenosismentioning

confidence: 99%

Surgical and Interventional Radiology Management of Vascular and Biliary Complications in Liver Transplantation: Narrative Review

Barragan,

Vera,

Hoyos

et al. 2023

Digestive Disease Interventions

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Liver transplant patients require a multidisciplinary and personalized approach to optimize outcomes. Posttransplant complications can be devastating for the patient and can jeopardize graft survival. Therefore, a careful evaluation and stepwise decision-making process is necessary to determine the best strategy, whether it is surgical, interventional, or a combination of both. While access to liver transplant interventions in Latin America can be more limited compared with other parts of the world, many countries in the region have made significant progress in developing their liver transplant programs and improving the management of posttransplant complications. For example, in Brazil, specialized transplant centers and multidisciplinary teams have been established to reduce morbidity and improve graft survival rates. The article also explores the latest advancements in interventional radiology techniques, such as angioplasty, stent placement, and embolization, and how they can be used to successfully treat these complications. Overall, this article highlights the importance of a comprehensive approach to managing complications in liver transplant patients and emphasizes how individualized treatment plans can lead to improved outcomes, even in settings with limited resources.

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Outcomes of Bariatric Surgery Before, During, and After Solid Organ Transplantation

2022

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Transplant Hepatic Artery Stenosis: Endovascular Treatment and Complications

Cited by 4 publications

References 17 publications

Current Endovascular Management of Arterial Complications After Pediatric Liver Transplantation in a Tertiary Center

Current Endovascular Management of Arterial Complications After Pediatric Liver Transplantation in a Tertiary Center

Surgical and Interventional Radiology Management of Vascular and Biliary Complications in Liver Transplantation: Narrative Review

Outcomes of Bariatric Surgery Before, During, and After Solid Organ Transplantation

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