Background: Vascular complication is life-threatening when it develops after living donor liver transplantation (LDLT) and interventional radiology (IVR) is a less-invasive therapeutic option comparing to surgical approaches to treat them. The aims of this study were to evaluate the short- and long-term efficacy of IVR treatment for vascular complications after LDLT.

Patients: Among the 151 patients of LDLT between March 2002 and October 2017, 24 (15.9%) patientsdeveloped vascular complications requiring IVR treatment: hepatic artery thrombosis (HAT) (n=9) and outflow block including stenosis of the anastomosis of hepatic vein (HV) (n=8) and inferior vena cava (IVC) (n=7).

Results: In nine patients developing HAT, the median age was 58 years old (43-63) and the median interval between LDLT and IVR treatment was 13 days (4-22). Transcatheter thrombolysis and percutaneous luminal angioplasty (PTA) was performed for all HAT cases. Overall technical success with IVR treatment was achieved in 77.8% (7 of 9) of the patients including 2 patients who required stent placement. Two patients with failure of revascularization by PTA were treated conservatively. After then hepatic arterial collaterals developed and both of them could avoid the graft failure. As to sixteen patients developing outflow block, the median age was 54 years old (4-69) and the median interval between LDLT and IVR treatment was 13 days (1-107). Stent placement was performed across the outflow block veins without any complications in all patients because of venous stenosis with a pressure gradient more than 5 mmHg. The patency of HA, HV and IVC had been kept in all patients after stent placement by checking Doppler ultrasonography. The longest follow-up time was 105 months in HA stent, 182 months in HV stent, and 178 months in IVC stent, respectively. The 1-, 3-, 5-year survival rates of patients with vascular complication (n=25) and without vascular complication (n=110) were 75.0, 75.0, 75.0 % vs. 81.7, 72.4, 67.2% (p=0.611).

Conclusions: IVR treatment including stent placement seems to be safe and effective treatment to treat post-transplant vascular complication in short and long term.

CITATION INFORMATION: Mizuno S., Nakatsuka A., Hayasaki A., Iizawa U., Kato H., Murata Y., Tanemura A., Kuriyama N., Azumi Y., Kishiwada M., Usui M., Sakurai H., Sakuma H., Isaji S. Short- and Long-Term Outcomes of Interventional Radiology Treatment for Vascular Complications Following Living Donor Liver Transplantation: The Efficacy of Stent Placement Am J Transplant. 2017;17 (suppl 3).

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