J Korean Radiol Soc.  2001 Jun;44(6):683-689. 10.3348/jkrs.2001.44.6.683.

Radiologic Management of Hepatic Arterial Stenosis or Thrombosis Following Liver Transplantation

• Shin BS
• Sung KB
• Lim SM
• Yoon HK
• Song HY

• KMID: 2158396
• DOI: http://doi.org/10.3348/jkrs.2001.44.6.683

Abstract

PURPOSE: To assess the results and usefulness of interventional procedures for hepatic arterial stenosis or thrombosis following liver transplantation.
MATERIALS AND METHODS
During the past five years, eight patients aged 1-59 (mean, 39) years among 187 liver transplant recipients showed elevated of liver enzyme levels (AST/ALT) and decreased arterial flow at Doppler ultrasound. Hepatic arteriography revealed luminal stenosis or occlusion at the proper hepatic artery, and six patients, one of whom required thrombolysis before the procedure, underwent percutaneous transluminal angioplasty (PTA) using a balloon. In two with thronbosis, thrombolysis without PTA was performed. In order to increase hepatic arterial flow, four patients underwent additional coil embolization of the gastroduodenal or splenic artery.
RESULTS
Hepatic arterial flow recovered in all six patients after PTA. Three required repeat PTA for restenosis and one of these needed stent placement after repeated PTA. At follow-up, 6-17 months later, the three had good hepatic function. Within four days, the other three expired due to graft failure, hepatorenal syndrome and sepsis. One of the patients who underwent thrombolysis without PTA expired and the other required retransplantation. In this case there were no procedure - related complications.
CONCLUSION
Radiologic interventions are useful for treatment of hepatic arterial stensis or thrombosis in patients with liver transplantations.

Keyword

Liver, transplantation,Surgery, complications; Hepatic arteries transluminal angioplasty Thrombolysis

MeSH Terms

Angiography
Angioplasty
Constriction, Pathologic*
Embolization, Therapeutic
Follow-Up Studies
Hepatic Artery
Hepatorenal Syndrome
Humans
Liver Transplantation*
Liver*
Phenobarbital
Sepsis
Splenic Artery
Stents
Thrombosis*
Transplantation
Transplants
Ultrasonography
Phenobarbital