SAFETY AND EFFICACY OF THE ENDOVASCULAR INTERVENTIONAL THERAPY FOR HEPATIC ARTERY COMPLICATIONS AFTER THE LIVER TRANSPLANTATION

Anu John, Qingyun Long*, Baolin Wu and Jun Zhou

ABSTRACT

Aim: To analyze the safety and efficacy of endovascular interventional treatment for hepatic artery complications after liver transplantation (LT). Materials and methods: Twelve patients who have undergone endovascular interventional treatment for the hepatic artery complications after liver transplantation were retrospectively analyzed. Techniques included catheter-directed thrombolysis (CDT), percutaneous transluminal angioplasty (PTA) and stent placement. Lesion characteristics, treatment techniques and outcomes were depicted and evaluated. Results: Five patients developed hepatic artery thrombosis (HAT), three patients developed hepatic artery stenosis (HAS), two patients developed HAT combined with HAS and two patients developed hepatic artery pseudoaneurysm (HAP). Ten patients were successfully treated, the primary technical success rate was 83% (10/12). Two cases were observed with complications during the procedure and treated subsequently. One patient was complicated by rupture during PTA and was treated with a graft-covered stent. Serum alanine aminotransaminase (ALT)，aspartate aminotransferase (AST), total bilirubin (TBil) and direct bilirubin (DBil) decreased remarkably (P ＜ 0.01) two weeks after the treatment. All successfully treated cases were followed up for 2-24 months, two patients underwent a repeated treatment due to restenosis and acute thrombosis after the operation. Conclusion: Endovascular interventional treatment is a safe, effective and minimally invasive technique and can be regarded as the first-line treatment for hepatic artery complications after LT for selected patients.

Keywords: Hepatocellular carcinoma, Transarterial chemoembolization, liver transplantation, Complications, Hepatic artery, Endovascular therapy.