Date: Monday, May 4, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Endovascular treatment of hepatic artery stenosis (HAS) after liver transplantation offers a less invasive alternative to surgical revision or retransplantation. However, outcomes following endovascular treatment remain ill-defined. We conducted a single center retrospective review of endovascular treatment of hepatic artery stenosis following liver transplantation from August 2009 – December 2013. Forty-two patients diagnosed with HAS on ultrasound (peak systolic velocity > 400 cm/sec, resistive index <0.5) underwent angioplasty alone or primary stent placement. Transplant characteristics included mean recipient age (51.2 ± 10.9), BMI (28.5 ± 6.6), MELD (23.1 ± 8.6), donor age (32.6 ± 15.1) and cold ischemia time (5.4 ± 1.6h). During the study period, the overall rate of hepatic artery stenosis was 6.4%. Sixty-two interventions were performed in 42 patients with HAS with a mean follow-up of 34.0 ± 13.3 months. Primary hepatic artery patency rates at 1, 6 and 12 months after initial intervention were significantly better for initial stent placement (91%, 81.3%, 77%) versus angioplasty alone (68.8%, 57.1%, 44%). Fourteen patients required re-intervention for recurrent stenosis (8 stents, 6 repeat angioplasties). Overall primary-assisted patency was 96 and 93% at 12 and 24 months, respectively. Major complications included one arterial rupture and two hepatic artery dissections. In the entire patient cohort, risk of hepatic artery thrombosis was 4.8%. Biliary strictures developed in 7 patients (16.6%) with only one diffuse-type cholangiopathy requiring retransplantation. All focal biliary strictures were successfully treated endoscopically. Graft survival rates at 6, 12 and 24 months after the initial endovascular were 92.7%, 87.7% and 79.2% respectively. Patient survival rates at 6, 12 and 24 months were 97.6%, 92.6% and 81.6% respectively. Endovascular treatment of critical hepatic artery stenosis offers a minimally invasive approach with high rates of primary patency and liver allograft survival. Initial use of a stent significantly decreased the need for re-intervention.
To cite this abstract in AMA style:Seal J, Bohorquez H, Le L, Terral W, Cohen A, Carmody I, Bruce D, Reichman T, Ahmed E, Sternbergh W, Loss G. Outcomes Following Endovascular Treatment of Hepatic Artery Stenosis Following Liver Transplantation [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/outcomes-following-endovascular-treatment-of-hepatic-artery-stenosis-following-liver-transplantation/. Accessed September 30, 2020.
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