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Erschienen in: CardioVascular and Interventional Radiology 2/2018

01.02.2018 | Clinical Investigation

Pretransplant Intra-arterial Liver-Directed Therapy Does Not Increase the Risk of Hepatic Arterial Complications in Liver Transplantation: A Single-Center 10-Year Experience

verfasst von: Joseph R. Kallini, Ahmed Gabr, Rehan Ali, Nadine Abouchaleh, Ahsun Riaz, Talia Baker, Laura Kulik, Juan Caicedo, Riad Salem, Robert J. Lewandowski

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 2/2018

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Abstract

Purpose

To investigate the association between pretransplant intra-arterial liver-directed therapy (IAT) for hepatocellular carcinoma (HCC) and hepatic arterial complications (HAC) in orthotopic liver transplantation (OLT) [namely hepatic artery thrombosis (HAT) and/or the need for hepatic arterial conduit].

Methods

A total of 175 HCC patients (mean age: 60 years) underwent IAT with either transarterial chemoembolization or yttrium-90 (90Y) transarterial radioembolization prior to OLT between 2003 and 2013. A matched control cohort of 159 HCC patients who underwent OLT without prior IAT was selected. Incidence of HAC in both cohorts was investigated. The categorical differences between both cohorts were calculated by chi-square test.

Results

Among the 175 patients (chemoembolization, n = 82; radioembolization, n = 93), 8 (5%) required conduits due to HA disease (chemoembolization, n = 6; radioembolization, n = 2), 3 (2%) developed HAT (chemoembolization, n = 2; radioembolization, n = 1). Eleven of 175 patients (6.7%) had HAC. Of the 159 control patients, 6 (4%) needed conduits for HA disease and 3 (2%) developed HAT. Nine of 159 patients (5.7%) had HAC. Chi-square analysis between the IAT cohort and the control group yielded a p value of 0.810. When comparing chemoembolization to radioembolization, p = 0.076 (not significant at p < 0.05).

Conclusion

Although aggressive pretransplant radioembolization and chemoembolization are both utilized in most liver transplant centers, neither appears to increase the risk of peri-transplant hepatic arterial complications in HCC patients.
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Metadaten
Titel
Pretransplant Intra-arterial Liver-Directed Therapy Does Not Increase the Risk of Hepatic Arterial Complications in Liver Transplantation: A Single-Center 10-Year Experience
verfasst von
Joseph R. Kallini
Ahmed Gabr
Rehan Ali
Nadine Abouchaleh
Ahsun Riaz
Talia Baker
Laura Kulik
Juan Caicedo
Riad Salem
Robert J. Lewandowski
Publikationsdatum
01.02.2018
Verlag
Springer US
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 2/2018
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-017-1793-z

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