Ammar Sarwar MD, Presenter: Nothing to Disclose

Ian Martin Brennan MBBCh, BMedSc, Abstract Co-Author: Nothing to Disclose

Olga Rachel Brook MD, Abstract Co-Author: Research Grant, Guerbet SA

Felipe Birchal Collares MD, Abstract Co-Author: Nothing to Disclose

Salomao Faintuch MD, Abstract Co-Author: Nothing to Disclose

Barry A. Sacks MD, Abstract Co-Author: Nothing to Disclose

Muneeb Ahmed MD, Abstract Co-Author: Nothing to Disclose

To determine clinical outcome in patients who underwent primary stent placement for hepatic artery (HA) stenosis after liver transplantation.

A retrospective review of all adult liver transplant patients needing HA stent (2003-2013) was performed. All imaging studies and clinical outcomes were recorded. Primary clinical outcomes (mortality, graft dysfunction) were assessed. As a secondary endpoint, primary patency was assessed using available imaging at 1 month and 1 year. 

20 pts (mean age: 54±11y, 10 male) fit inclusion criteria and had 26 HA stents, (mean 185±213 days (d)) after transplant. Overall, 20/26 stents in 16/20 patients were patent within the time period reviewed. Clinical follow-up was available in 18/20 patients (Mean 1173±1040d). Two patients were alive with no graft dysfunction but lost to follow-up at 1323 and 1742 days. Overall mortality was 77% (14/18). Graft dysfunction related mortality was 0%. Re-transplantation related to HA stenosis was needed in 1 patient who required 3 separate stents. In patients with at least 2 years (n=15) and 5 year clinical follow-up (n=4), none had HA-related graft dysfunction or HA-related mortality. Of the 5 patients with less than 2 year clinical follow-up, 1 required re-transplantation due to HA thrombosis and 2 died due to non-graft dysfunction related causes. At least 1 year imaging follow-up was available in 24/26 stents. Primary patency was 96% at 30 days and 75% at 1 year. Primary assisted patency was 79% at 1 year. In 3 patients with hepatic arterial occlusion on imaging, one needed re-transplantation (occlusion 14 days post-stenting) and two are doing well with no graft dysfunction (occlusion 44 days and 728 days post-stenting).  

Primary stenting for HA stenosis has very good clinical outcomes and high primary patency rates. Late occlusions (>30d) do not necessarily lead to graft dysfunction.

Hepatic arterial stenosis is an uncommon complication after liver transplantation. Successful percutaneous therapy with good long term outcomes may preclude need for surgical revision.

Sarwar, A, Brennan, I, Brook, O, Collares, F, Faintuch, S, Sacks, B, Ahmed, M, Primary Hepatic Arterial Stenting in Patients after Liver Transplantation: 1 Year Patency Rates and Long Term Clinical Outcomes.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14019421.html