Background: Vascular complication after liver transplantation sometimes leads to graft loss. The aims of this study were to evaluate the efficacy of stent placement for anastomosis of hepatic artery (HA), hepatic vein (HV), and inferior vena cava (IVC) after living donor liver transplantation (LDLT)

Methods: Among the 135 patients of LDLT between March 2002 and October 2012, 25 (18.5%) cases occurred vascular complication: hepatic artery thrombosis (HAT) (n=7), stenosis of the anastomosis of portal vein (n=3), HV (n=9), and IVC (n=7). Transcatheter thrombolysis was performed for all HAT cases, and reoperation was undergone in all cases of portal venous complication and one HV stenosis case. Stent placement was performed in HA (n=3) and in HV (n=9) and IVC (n=7) because of stenosis of the anastomosis.

Results: The median interval between LDLT and stent placement was 16 days (8-25) in HA, 20 days (2-63) in HV, and 19 days (9-34) in IVC. Technical success in stent placement was achieved in all patients and no major complication occurred. The patency of HA, HV and IVC have been kept in all patients after stent placement by checking Doppler ultrasonography. The longest follow-up time was 70 months in HA stent, 117 months in HV stent, and 113 months in IVC stent, respectively. In multivariate analysis, the independent risk factor of posttransplant vascular complication was the induction of renal replacement therapy. 1, 3 year survival rates of patients with vascular complication (n=25) and without vascular complication (n=110) were 65.0%, 65.0% v.s. 83.5%, 75.9% (p=0.172).

Conclusions: Primary stent placement seems to be a safety and effective treatment modality with an acceptable long-term patency to treat post-transplant vascular complication.

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