Risk of Hepatic Artery Complications After Liver Transplantation in Patients Who Received Pretransplant Transarterial Chemoembolization Therapy: A Single-Center Experience. Transplant Proc 2023 Sep;55(7):1631-1637
Date
07/01/2023Pubmed ID
37391331DOI
10.1016/j.transproceed.2023.03.084Scopus ID
2-s2.0-85163800123 (requires institutional sign-in at Scopus site) 2 CitationsAbstract
BACKGROUND: Pretransplant transarterial chemoembolization (TACE) for patients with hepatocellular carcinoma (HCC) has been associated with an increased risk of hepatic artery thrombosis (HAT) after liver transplantation (LT). Innovative surgical LT and interventional vascular radiology TACE techniques may mitigate the risk of HAT. We sought to investigate the incidence of HAT after LT in patients who received pre-transplant TACE at our center.
METHODS: We performed a single-center retrospective review of all LT patients, >18 years of age, from October 1, 2012, to May 31, 2018. Outcomes were compared between patients who received pre-LT TACE and those who did not. Median follow-up was 26 months.
RESULTS: Among the 162 LT recipients, 110 (67%) patients did not receive pre-LT TACE (Group I), while 52 (32%) received pre-LT TACE (Group II). The <30-day incidence rates of post-LT HAT were as follows: Group I = 1.8% and Group II = 1.9% (P = .9). Most hepatic arterial complications occurred >30 days after LT. Based on competing risks regression analysis, TACE was not associated with an increased risk of HAT. Patient or graft survivals were comparable between the 2 groups (P = .1 and .2, respectively).
CONCLUSIONS: Our study shows a similar incidence of hepatic artery complications post-LT in patients who received TACE before LT compared with those who did not. In addition, we suggest that the surgical technique of early vascular control of the common hepatic artery during LT, in combination with a super-selective vascular intervention radiology approach, has clinical utility in reducing the risk of HAT in patients requiring pre-transplant TACE.
Author List
Selim M, Hohenwalter EJ, Rilling WS, Hong JCAuthors
Eric J. Hohenwalter MD Chief, Professor in the Radiology department at Medical College of WisconsinWilliam S. Rilling MD Vice Chair, Professor in the Radiology department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Carcinoma, HepatocellularChemoembolization, Therapeutic
Hepatic Artery
Humans
Liver Neoplasms
Liver Transplantation
Retrospective Studies
Thrombosis
Treatment Outcome
