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08.11.2018 | Clinical Investigation

Endovascular Treatment of Arterial Complications After Liver Transplantation: Long-Term Follow-Up Evaluated on Doppler Ultrasound and Magnetic Resonance Cholangiopancreatography

verfasst von: Romain Breguet, Federica Dondero, Lawrence Pupulim, Nicolas Goossens, Ailton Sepulveda, Claire Francoz, François Durand, Sylvain Terraz, Valérie Vilgrain, Maxime Ronot

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 3/2019

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Abstract

Purpose

To evaluate long-term arterial patency and abnormalities of bile ducts in patients that had endovascular treatment for arterial complications after liver transplantation (LT).

Materials and Methods

Between 2004 and 2014, 1048 LTs were consecutively performed in our institution and 53 patients (42 men; age range 19–69) were diagnosed and treated by endovascular techniques for arterial complications such as stenosis, thrombosis, dissection or kinking of the hepatic artery (HA). Radiological and surgical data were retrospectively analyzed, and survivors were contacted to undergo follow-up Doppler ultrasound (DUS) of the HA and magnetic resonance cholangiopancreatography.

Results

The primary technical success of endovascular treatment was 94% (n = 50). The patency rate of HA at 5-year was 81%. After a median follow-up of 58 months, 17 patients (32%) developed radiological features of ischemic cholangiopathy (IC), including 7 patients with abnormal DUS and 10 with normal DUS. Patients who presented with complications of the HA in the first 3 months after LT developed IC more frequently (42%) than others (12%) (p = 0.028). No other factor was associated with the development of IC.

Conclusion

IC was more often observed when HA complication occurred within the first 3 months after LT. The presence of IC was not excluded by a normal DUS during follow-up.
Literatur
1.
Zurück zum Zitat Wojcicki M, Milkiewicz P, Silva M. Biliary tract complications after liver transplantation: a review. Dig Surg. 2008;25:245–57.CrossRefPubMed Wojcicki M, Milkiewicz P, Silva M. Biliary tract complications after liver transplantation: a review. Dig Surg. 2008;25:245–57.CrossRefPubMed
2.
Zurück zum Zitat Kienlein S, Schoening W, Andert A, Kroy D, Neumann UP, Schmeding M. Biliary complications in liver transplantation: impact of anastomotic technique and ischemic time on short- and long-term outcome. World J Transplant. 2015;5:300–9.CrossRefPubMedPubMedCentral Kienlein S, Schoening W, Andert A, Kroy D, Neumann UP, Schmeding M. Biliary complications in liver transplantation: impact of anastomotic technique and ischemic time on short- and long-term outcome. World J Transplant. 2015;5:300–9.CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Mourad MM, Algarni A, Liossis C, Bramhall SR. Aetiology and risk factors of ischaemic cholangiopathy after liver transplantation. World J Gastroenterol. 2014;20:6159–69.CrossRefPubMedPubMedCentral Mourad MM, Algarni A, Liossis C, Bramhall SR. Aetiology and risk factors of ischaemic cholangiopathy after liver transplantation. World J Gastroenterol. 2014;20:6159–69.CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Cotroneo AR, Di Stasi C, Cina A, De Gaetano AM, Evangelisti R, Paloni F, et al. Stent placement in four patients with hepatic artery stenosis or thrombosis after liver transplantation. J Vasc Interv Radiol. 2002;13:619–23.CrossRefPubMed Cotroneo AR, Di Stasi C, Cina A, De Gaetano AM, Evangelisti R, Paloni F, et al. Stent placement in four patients with hepatic artery stenosis or thrombosis after liver transplantation. J Vasc Interv Radiol. 2002;13:619–23.CrossRefPubMed
5.
Zurück zum Zitat Bekker J, Ploem S, de Jong KP. Early hepatic artery thrombosis after liver transplantation: a systematic review of the incidence, outcome and risk factors. Am J Transplant. 2009;9:746–57.CrossRefPubMed Bekker J, Ploem S, de Jong KP. Early hepatic artery thrombosis after liver transplantation: a systematic review of the incidence, outcome and risk factors. Am J Transplant. 2009;9:746–57.CrossRefPubMed
6.
Zurück zum Zitat Pareja E, Cortes M, Navarro R, Sanjuan F, Lopez R, Mir J. Vascular complications after orthotopic liver transplantation: hepatic artery thrombosis. Transplant Proc. 2010;42:2970–2.CrossRefPubMed Pareja E, Cortes M, Navarro R, Sanjuan F, Lopez R, Mir J. Vascular complications after orthotopic liver transplantation: hepatic artery thrombosis. Transplant Proc. 2010;42:2970–2.CrossRefPubMed
7.
Zurück zum Zitat Vignali C, Bargellini I, Cioni R, Petruzzi P, Cicorelli A, Lazzereschi M, et al. Diagnosis and treatment of hepatic artery stenosis after orthotopic liver transplantation. Transplant Proc. 2004;36:2771–3.CrossRefPubMed Vignali C, Bargellini I, Cioni R, Petruzzi P, Cicorelli A, Lazzereschi M, et al. Diagnosis and treatment of hepatic artery stenosis after orthotopic liver transplantation. Transplant Proc. 2004;36:2771–3.CrossRefPubMed
8.
Zurück zum Zitat Hamby BA, Ramirez DE, Loss GE, Bazan HA, Smith TA, Bluth E, et al. Endovascular treatment of hepatic artery stenosis after liver transplantation. J Vasc Surg. 2013;57:1067–72.CrossRefPubMed Hamby BA, Ramirez DE, Loss GE, Bazan HA, Smith TA, Bluth E, et al. Endovascular treatment of hepatic artery stenosis after liver transplantation. J Vasc Surg. 2013;57:1067–72.CrossRefPubMed
9.
Zurück zum Zitat Le L, Terral W, Zea N, Bazan HA, Smith TA, Loss GE, et al. Primary stent placement for hepatic artery stenosis after liver transplantation. J Vasc Surg. 2015;62:704–9.CrossRefPubMed Le L, Terral W, Zea N, Bazan HA, Smith TA, Loss GE, et al. Primary stent placement for hepatic artery stenosis after liver transplantation. J Vasc Surg. 2015;62:704–9.CrossRefPubMed
10.
Zurück zum Zitat Chen GH, Wang GY, Yang Y, Li H, Lu MQ, Cai CJ, et al. Single-center experience of therapeutic management of hepatic artery stenosis after orthotopic liver transplantation. Report of 20 cases. Eur Surg Res. 2009;42:21–7.CrossRefPubMed Chen GH, Wang GY, Yang Y, Li H, Lu MQ, Cai CJ, et al. Single-center experience of therapeutic management of hepatic artery stenosis after orthotopic liver transplantation. Report of 20 cases. Eur Surg Res. 2009;42:21–7.CrossRefPubMed
11.
Zurück zum Zitat Kodama Y, Sakuhara Y, Abo D, Shimamura T, Furukawa H, Todo S, et al. Percutaneous transluminal angioplasty for hepatic artery stenosis after living donor liver transplantation. Liver Transpl. 2006;12:465–9.CrossRefPubMed Kodama Y, Sakuhara Y, Abo D, Shimamura T, Furukawa H, Todo S, et al. Percutaneous transluminal angioplasty for hepatic artery stenosis after living donor liver transplantation. Liver Transpl. 2006;12:465–9.CrossRefPubMed
12.
Zurück zum Zitat Lastovickova J, Peregrin J. Percutaneous transluminal angioplasty of hepatic artery stenosis in patients after orthotopic liver transplantation: mid-term results. Cardiovasc Intervent Radiol. 2011;34:1165–71.CrossRefPubMed Lastovickova J, Peregrin J. Percutaneous transluminal angioplasty of hepatic artery stenosis in patients after orthotopic liver transplantation: mid-term results. Cardiovasc Intervent Radiol. 2011;34:1165–71.CrossRefPubMed
13.
Zurück zum Zitat Maruzzelli L, Miraglia R, Caruso S, Milazzo M, Mamone G, Gruttadauria S, et al. Percutaneous endovascular treatment of hepatic artery stenosis in adult and pediatric patients after liver transplantation. Cardiovasc Intervent Radiol. 2010;33:1111–9.CrossRefPubMed Maruzzelli L, Miraglia R, Caruso S, Milazzo M, Mamone G, Gruttadauria S, et al. Percutaneous endovascular treatment of hepatic artery stenosis in adult and pediatric patients after liver transplantation. Cardiovasc Intervent Radiol. 2010;33:1111–9.CrossRefPubMed
14.
Zurück zum Zitat Rostambeigi N, Hunter D, Duval S, Chinnakotla S, Golzarian J. Stent placement versus angioplasty for hepatic artery stenosis after liver transplant: a meta-analysis of case series. Eur Radiol. 2013;23:1323–34.CrossRefPubMed Rostambeigi N, Hunter D, Duval S, Chinnakotla S, Golzarian J. Stent placement versus angioplasty for hepatic artery stenosis after liver transplant: a meta-analysis of case series. Eur Radiol. 2013;23:1323–34.CrossRefPubMed
15.
Zurück zum Zitat Saad WE, Davies MG, Sahler L, Lee DE, Patel NC, Kitanosono T, et al. Hepatic artery stenosis in liver transplant recipients: primary treatment with percutaneous transluminal angioplasty. J Vasc Interv Radiol. 2005;16:795–805.CrossRefPubMed Saad WE, Davies MG, Sahler L, Lee DE, Patel NC, Kitanosono T, et al. Hepatic artery stenosis in liver transplant recipients: primary treatment with percutaneous transluminal angioplasty. J Vasc Interv Radiol. 2005;16:795–805.CrossRefPubMed
16.
Zurück zum Zitat Sabri SS, Saad WE, Schmitt TM, Turba UC, Kumer SC, Park AW, et al. Endovascular therapy for hepatic artery stenosis and thrombosis following liver transplantation. Vasc Endovascular Surg. 2011;45:447–52.CrossRefPubMed Sabri SS, Saad WE, Schmitt TM, Turba UC, Kumer SC, Park AW, et al. Endovascular therapy for hepatic artery stenosis and thrombosis following liver transplantation. Vasc Endovascular Surg. 2011;45:447–52.CrossRefPubMed
17.
Zurück zum Zitat Abbasoglu O, Levy MF, Brkic BB, Testa G, Jeyarajah DR, Goldstein RM, et al. Ten years of liver transplantation: an evolving understanding of late graft loss. Transplantation. 1997;64:1801–7.CrossRefPubMed Abbasoglu O, Levy MF, Brkic BB, Testa G, Jeyarajah DR, Goldstein RM, et al. Ten years of liver transplantation: an evolving understanding of late graft loss. Transplantation. 1997;64:1801–7.CrossRefPubMed
18.
Zurück zum Zitat Duffy JP, Hong JC, Farmer DG, Ghobrial RM, Yersiz H, Hiatt JR, et al. Vascular complications of orthotopic liver transplantation: experience in more than 4,200 patients. J Am Coll Surg. 2009;208:896–903.CrossRefPubMed Duffy JP, Hong JC, Farmer DG, Ghobrial RM, Yersiz H, Hiatt JR, et al. Vascular complications of orthotopic liver transplantation: experience in more than 4,200 patients. J Am Coll Surg. 2009;208:896–903.CrossRefPubMed
19.
Zurück zum Zitat Hsiao CY, Ho CM, Wu YM, Ho MC, Hu RH, Lee PH. Management of early hepatic artery occlusion after liver transplantation with failed rescue. World J Gastroenterol. 2015;21:12729–34.CrossRefPubMedPubMedCentral Hsiao CY, Ho CM, Wu YM, Ho MC, Hu RH, Lee PH. Management of early hepatic artery occlusion after liver transplantation with failed rescue. World J Gastroenterol. 2015;21:12729–34.CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Orons PD, Sheng R, Zajko AB. Hepatic artery stenosis in liver transplant recipients: prevalence and cholangiographic appearance of associated biliary complications. AJR Am J Roentgenol. 1995;165:1145–9.CrossRefPubMed Orons PD, Sheng R, Zajko AB. Hepatic artery stenosis in liver transplant recipients: prevalence and cholangiographic appearance of associated biliary complications. AJR Am J Roentgenol. 1995;165:1145–9.CrossRefPubMed
21.
Zurück zum Zitat Pulitano C, Joseph D, Sandroussi C, Verran D, Strasser SI, Shackel NA, et al. Hepatic artery stenosis after liver transplantation: is endovascular treatment always necessary? Liver Transpl. 2015;21:162–8.CrossRefPubMed Pulitano C, Joseph D, Sandroussi C, Verran D, Strasser SI, Shackel NA, et al. Hepatic artery stenosis after liver transplantation: is endovascular treatment always necessary? Liver Transpl. 2015;21:162–8.CrossRefPubMed
22.
Zurück zum Zitat Low G, Crockett AM, Leung K, Walji AH, Patel VH, Shapiro AM, et al. Imaging of vascular complications and their consequences following transplantation in the abdomen. Radiographics. 2013;33:633–52.CrossRefPubMed Low G, Crockett AM, Leung K, Walji AH, Patel VH, Shapiro AM, et al. Imaging of vascular complications and their consequences following transplantation in the abdomen. Radiographics. 2013;33:633–52.CrossRefPubMed
23.
Zurück zum Zitat Boraschi P, Donati F. Postoperative biliary adverse events following orthotopic liver transplantation: assessment with magnetic resonance cholangiography. World J Gastroenterol. 2014;20:11080–94.CrossRefPubMedPubMedCentral Boraschi P, Donati F. Postoperative biliary adverse events following orthotopic liver transplantation: assessment with magnetic resonance cholangiography. World J Gastroenterol. 2014;20:11080–94.CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Boraschi P, Donati F, Gigoni R, Urbani L, Femia M, Cossu MC, et al. Ischemic-type biliary lesions in liver transplant recipients: evaluation with magnetic resonance cholangiography. Transplant Proc. 2004;36:2744–7.CrossRefPubMed Boraschi P, Donati F, Gigoni R, Urbani L, Femia M, Cossu MC, et al. Ischemic-type biliary lesions in liver transplant recipients: evaluation with magnetic resonance cholangiography. Transplant Proc. 2004;36:2744–7.CrossRefPubMed
25.
Zurück zum Zitat de Vries Y, von Meijenfeldt FA, Porte RJ. Post-transplant cholangiopathy: Classification, pathogenesis, and preventive strategies. Biochim Biophys Acta. 2017. de Vries Y, von Meijenfeldt FA, Porte RJ. Post-transplant cholangiopathy: Classification, pathogenesis, and preventive strategies. Biochim Biophys Acta. 2017.
26.
Zurück zum Zitat Iida T, Kaido T, Yagi S, Hori T, Uchida Y, Jobara K, et al. Hepatic arterial complications in adult living donor liver transplant recipients: a single-center experience of 673 cases. Clin Transplant. 2014;28:1025–30.CrossRefPubMed Iida T, Kaido T, Yagi S, Hori T, Uchida Y, Jobara K, et al. Hepatic arterial complications in adult living donor liver transplant recipients: a single-center experience of 673 cases. Clin Transplant. 2014;28:1025–30.CrossRefPubMed
27.
Zurück zum Zitat Rana A, Hardy MA, Halazun KJ, Woodland DC, Ratner LE, Samstein B, et al. Survival outcomes following liver transplantation (SOFT) score: a novel method to predict patient survival following liver transplantation. Am J Transplant. 2008;8:2537–46.CrossRefPubMed Rana A, Hardy MA, Halazun KJ, Woodland DC, Ratner LE, Samstein B, et al. Survival outcomes following liver transplantation (SOFT) score: a novel method to predict patient survival following liver transplantation. Am J Transplant. 2008;8:2537–46.CrossRefPubMed
28.
Zurück zum Zitat Aranzana EM, Coppini AZ, Ribeiro MA, Massarollo PC, Szutan LA, Ferreira FG. Model for End-Stage Liver Disease, Model for Liver Transplantation Survival and Donor Risk Index as predictive models of survival after liver transplantation in 1006 patients. Clinics (Sao Paulo). 2015;70:413–8.CrossRefPubMed Aranzana EM, Coppini AZ, Ribeiro MA, Massarollo PC, Szutan LA, Ferreira FG. Model for End-Stage Liver Disease, Model for Liver Transplantation Survival and Donor Risk Index as predictive models of survival after liver transplantation in 1006 patients. Clinics (Sao Paulo). 2015;70:413–8.CrossRefPubMed
Metadaten
Titel
Endovascular Treatment of Arterial Complications After Liver Transplantation: Long-Term Follow-Up Evaluated on Doppler Ultrasound and Magnetic Resonance Cholangiopancreatography
verfasst von
Romain Breguet
Federica Dondero
Lawrence Pupulim
Nicolas Goossens
Ailton Sepulveda
Claire Francoz
François Durand
Sylvain Terraz
Valérie Vilgrain
Maxime Ronot
Publikationsdatum
08.11.2018
Verlag
Springer US
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 3/2019
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-018-2108-8

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