학술논문

Endovascular Therapy of Arterial Complications Within the First Week After Liver Transplant.
Document Type
Article
Source
Transplantation Proceedings. Jun2020, Vol. 52 Issue 5, p1464-1467. 4p.
Subject
*ENDOVASCULAR surgery
*LIVER transplantation
*THERAPEUTIC complications
*HEPATIC artery
*DOPPLER ultrasonography
*INTERVENTIONAL radiology
Language
ISSN
0041-1345
Abstract
Recent radiologic advances have made endovascular treatment a very successful option for arterial complications after liver transplant. This article presents our experience of using endovascular treatments during the first week after liver transplant. This study is a retrospective, single-center analysis. Liver transplants performed between 2010 and 2018 were analyzed. All patients underwent Doppler ultrasonography on days 1 and 7. Endovascular therapy was indicated in hepatic artery thrombosis diagnosed early after transplant and in stenosis when hepatic narrowing was > 70%. Patients were treated with subcutaneous anticoagulant therapy and with antiplatelet agents after endovascular therapy. Seven patients (1.1%) were included in the study. Stenosis was the reason in 5 patients while 2 patients had symptoms of thrombosis. The first 2 patients were initially treated with angioplasty; both had restenosis and were treated with angioplasty and stent placement, respectively. The 5 most recent patients received stenting as a primary treatment. Two of these patients developed a new stenosis. No patient developed any hepatic artery complication related to the procedure, and only 1 patient experienced a postprocedure complication (femoral artery pseudoaneurysm), which was managed conservatively. No patient required retransplant. After a median follow-up of 48 months (range, 35-85 months) 1 patient had died, and the rest were alive and asymptomatic. Although there is scant experience of the use of endovascular therapy very shortly after liver transplant, recent advances in interventional radiology have made the technique feasible and safe, and it achieves a high success rate. • Endovascular therapies are not recommended early after transplant. • We present endovascular treatments during the first week after transplant. • Seven patients are presented: 2 with hepatic artery thrombosis and 5 with stenosis. • No patient developed any hepatic artery complication related with the procedure. • Four patients required a second procedure, but no patient required retransplant. [ABSTRACT FROM AUTHOR]