Role of Interventional Radiology in the Management of Early Vascular Complications After Liver Transplant

Igus, Behlul; Boyvat, Fatih; Ozen, Ozgur; Soy, Ebru H. Ayvazoglu; Karakaya, mre; Haberal, Mehmet

doi:10.6002/ect.2022.0244

Cited by 5 publications

(5 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…CDUS is the primary and most easily available modality, as it is easily repeatable, sensitive, cost-effective [ 9 , 15 ] and provides real-time information on the blood flow [ 16 , 17 ]. A routine CDUS follow-up protocol is not standardized, varying from centers that perform CDUS only in case of clinical alterations after the second post-transplant day [ 18 ] to centers that rely on CDUS every 12 h [ 8 ]. A prompt integration of functional CDUS data with morphological information provided by CTA is fundamental to characterize vascular anatomy.…”

Section: Discussionmentioning

confidence: 99%

“…Literature reports effective treatment of stenosis of the HA in adult LT patients [ 31 ]. The decision between PTA alone or stenting should be based on features like morphology of the stenosis, tortuosity and kinking of the arteries, reserving PTA for shorter and focal stenoses [ 8 , 13 , 32 , 33 ]. A recent retrospective study [ 34 ] showed comparable outcomes of PTA with or without stenting, with slightly higher stenosis relapse after PTA alone.…”

Section: Discussionmentioning

confidence: 99%

“…Pseudoaneurysms are rare but may lead to fatal bleeding [ 6 ]. Currently, it has been suggested that endovascular treatment could be an alternative to surgery or re-transplantation even for early-onset complications, as it is less invasive, burdened by lower rates of morbidity and mortality, with similar long-term overall survival [ 7 , 8 ]. However, it is not universally adopted and techniques are not standardized yet.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Current Endovascular Management of Arterial Complications After Pediatric Liver Transplantation in a Tertiary Center

Marra,

Muglia,

Capodaglio

et al. 2023

Cardiovasc Intervent Radiol

View full text Add to dashboard Cite

Purpose Pediatric liver transplant surgery is burdened by arterial complications whose endovascular treatment is not standardized. We report the outcomes of a cohort of pediatric recipients with hepatic artery complications treated by endoluminal procedures. Materials and Methods From December 2019 to December 2022, consecutive transplanted pediatric patients who underwent endovascular treatment of hepatic artery complications were reviewed. The analysis included: type of complication (occlusion, stenosis, pseudoaneurysm); onset (acute = < 15 days, subacute = 15–90 days, late = > 90 days); endovascular technique (angioplasty, stenting); complications and outcomes. Technical success was defined as the opacification of the hepatic artery at the final angiogram with < 50% residual stenosis and no pseudoaneurysms. Clinical success was defined by graft’s and patient’s survival. Results Seventeen patients (8 males; median age 33 months, IQR 9–103) underwent 21 hepatic arteriography procedures for predominantly acute or subacute occlusions (n = 7) or stenosis (n = 11) with concurrent pseudoaneurysms (n = 4). Primary and secondary technical success was achieved in 13/18 and 3/3 procedures, respectively, with overall technical success of 76%. Angioplasty alone was successful in 5/21 procedures; stent-retriever thrombectomy was performed in one occlusion with thrombosis; stenting was required in 9/17 (53%) patients. Clinical success was obtained in 14/17 (82%) patients with hepatic artery patency after a median of 367 days (IQR 114.5–500). Clinical failure occurred in 3 permanent occlusions, with 2 deaths and 1 re-transplantation. Procedure-related complications included minor events in 3/17 (18%) patients and 1/17 (6%) death. Conclusion In liver transplanted children with hepatic artery complications, endovascular treatment may provide clinical success, with stenting often required in acute and subacute conditions. Level of Evidence Level 4. Graphical Abstract

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Current Endovascular Management of Arterial Complications After Pediatric Liver Transplantation in a Tertiary Center

Marra,

Muglia,

Capodaglio

et al. 2023

Cardiovasc Intervent Radiol

View full text Add to dashboard Cite

show abstract

“…Se pueden clasificar en complicaciones vasculares oclusivas, como trombosis y estenosis 4,6 . La complejidad del compromiso trombótico postoperatorio en el caso de la trombosis de la arteria hepática (TAH) y la trombosis de la vena porta (TVP), está en relación directa con disfunción del injerto y desenlaces postquirúrgicos fatales por disminución del suministro vascular en el injerto 3,[8][9][10] .…”

Section: Introductionunclassified

“…El diagnóstico temprano y el abordaje terapéutico inmediato permiten mejorar la sobrevida en este tipo de complicaciones 5,6 . Durante el periodo postquirúrgico, la ecografía doppler es una alternativa útil y no genera ningún tipo de riesgo en el momento de valorar los pacientes con sospecha de compromiso vascular [8][9][10] . La tomografía computarizada con contraste se puede emplear en los casos que la ecografía no sea concluyente y en aquellos pacientes que requieren evaluación vascular anatómica más detallada, mientras la angiografía se recomienda cuando se sospecha una anomalía de la arteria hepática no confirmada por otro método.…”

Section: Introductionunclassified

Complicaciones vasculares postrasplante hepático, una situación con alta morbimortalidad

Tarazona-León,

Vanegas-Ballesteros,

Vergara

et al. 2024

Rev Colomb Cir

View full text Add to dashboard Cite

Introducción. El trasplante hepático es el tratamiento indicado en aquellas enfermedades del hígado en las cuales ya se han agotado otras medidas terapéuticas, y es un procedimiento complejo. Las complicaciones postquirúrgicas se relacionan con alta morbimortalidad y pueden llevar a desenlaces fatales; las complicaciones vasculares son las de mayor mortalidad, por lo que es crucial la detección temprana y el tratamiento oportuno. El objetivo de este estudio fue caracterizar los pacientes que presentaron complicaciones vasculares posterior a trasplante hepático. Métodos. Estudio descriptivo, retrospectivo, con seguimiento a los pacientes sometidos a trasplante hepático en la Fundación Cardiovascular, entre los años 2013 y 2023, que presentaron complicaciones vasculares. Se evaluó el tipo de complicación, los factores de riesgo y los desenlaces postquirúrgicos. Resultados. Se incluyeron en total 82 pacientes trasplantados, con un predominio del sexo masculino 59,8 % (n=49); la principal indicación del trasplante fue el alcoholismo (21,9 %). Veinte pacientes presentaron complicaciones vasculares; la más frecuente fue trombosis de arteria hepática, en el 45 % (n=9). En tres de estos casos se requirió nuevo trasplante. Conclusión. Las complicaciones vasculares empeoran la evolución clínica postoperatoria de los pacientes y están relacionadas con alta morbimortalidad, por lo cual es crucial la valoración multidisciplinaria, el diagnóstico oportuno y la intervención temprana para disminuir los desenlaces fatales.

show abstract

Metallic Stents for Hepatic Venous Outflow Obstruction After Living-Donor Liver Transplantation and their Therapeutic Effects

Nagata,

Akamatsu,

Shibata

et al. 2024

Transplantation Proceedings

View full text Add to dashboard Cite

Role of Interventional Radiology in the Management of Early Vascular Complications After Liver Transplant

Cited by 5 publications

References 1 publication

Current Endovascular Management of Arterial Complications After Pediatric Liver Transplantation in a Tertiary Center

Current Endovascular Management of Arterial Complications After Pediatric Liver Transplantation in a Tertiary Center

Complicaciones vasculares postrasplante hepático, una situación con alta morbimortalidad

Metallic Stents for Hepatic Venous Outflow Obstruction After Living-Donor Liver Transplantation and their Therapeutic Effects

Contact Info

Product

Resources

About