Emergency interventional endovascular treatment for early disorder of arterial blood flow in the liver graft
Open Access
- 15 December 2021
- journal article
- Published by IPO Association of Transplantologists in Transplantologiya
- Vol. 13 (4), 367-381
- https://doi.org/10.23873/2074-0506-2021-13-4-367-381
Abstract
Introduction. Liver transplantation is considered the most effective treatment for patients with end-stage liver disease. X-ray endovascular interventions show good results in the treatment of vascular complications after transplantation. The timing, indications and choice of treatment methods require clarification.Objective. To evaluate the safety and efficacy of emergency X-ray endovascular interventions for arterial complications in the early period after liver transplantation.Material and methods. In the period from October 2016 by July 2021, 88 liver transplants were performed. The graft was obtained from a posthumous donor in 75 cases, and from a living donor (right lobe of the liver) in 13 cases. Arterial complications were registered in 10 cases: thrombosis of the hepatic artery in 7 (8.0%), constriction in 3 (3.4%); 4 patients underwent retransplantation due to thrombosis. This analysis included 6 patients aged 27 to 51 years, including 4 men and 2 women. In the early postoperative period (0–14 days), according to laboratory parameters, ultrasound Doppler, and computed tomography with a contrast agent, an impairment of the arterial blood supply of the graft was revealed, for which the patients underwent emergency X-ray image-guided surgical endovascular interventions.Results. Restoration of adequate arterial blood supply to the liver graft was achieved in all six patients. At the time of this writing, the graft function and patency of the hepatic artery were preserved at follow-up periods of 6, 11, 12, 22 (in two patients), and 26 months with a median of 17 months. Four patients developed biliary complications that required surgical correction.Conclusion. X-ray image-guided endovascular interventions can be considered effective and relatively safe in the treatment of patients with arterial complications after liver transplantation. The period of graft arterial ischemia should be minimized as much as possible in order to prevent biliary complications.Keywords
This publication has 20 references indexed in Scilit:
- Endovascular Treatment for Very Early Hepatic Artery Stenosis Following Living-Donor Liver Transplantation: Report of Two CasesTransplantation Proceedings, 2018
- Complications after endovascular treatment of hepatic artery stenosis after liver transplantationJournal of Vascular Surgery, 2017
- Interventional Treatment for Hepatic Artery Thrombosis after Liver TransplantationJournal of Vascular and Interventional Radiology, 2017
- Vascular complications after orthotopic liver transplantationTransplantologiya, 2017
- SPLENIC ARTERY EMBOLIZATION IN PATIENTS UNDERGOING ORTHOTOPIC LIVER TRANSPLANTATIONRussian Journal of Transplantology and Artificial Organs, 2016
- Vascular complications following liver transplantation: A literature review of advances in 2015World Journal of Hepatology, 2016
- Primary stent placement for hepatic artery stenosis after liver transplantationJournal of Vascular Surgery, 2015
- Postoperative doppler evaluation of liver transplantsIndian Journal of Radiology and Imaging, 2014
- Endovascular treatment of hepatic artery stenosis after liver transplantationJournal of Vascular Surgery, 2013
- Stent placement versus angioplasty for hepatic artery stenosis after liver transplant: a meta-analysis of case seriesEuropean Radiology, 2012