Hepatic artery stenosis after liver transplantation - Incidence, presentation, treatment, and long term outcome

Osman Abbasoglu, Marlon F. Levy, Mohan S. Vodapally, Robert M. Goldstein, Bo S. Husberg, Thomas A. Gonwa, Goran B. Klintmalm

Research output: Contribution to journalArticle

185 Citations (Scopus)

Abstract

Little is known about hepatic artery (HA) patency and patient clinical course when the nonthrombosed HA has been revised. We undertook this study to evaluate the risk factors in the development of HA stenosis and to assess the impact of HA revision on the outcome. A total of 857 adult consecutive OLT in 780 patients performed over a 6-year period were studied. Patients who underwent revision of their nonthrombosed but stenotic HA were reviewed for patient/graft survival, method of HA revision, incidence of biliary strictures, and long-term HA patency. Overall 39 patients (5%) with 41 allografts underwent HA revision for stenosis. Median time to diagnosis was 100 days posttransplant (range 1-1220 days). HA flow at the time of OLT was found to be the only significant variable of an anastomotic stenosis. No risk factor could be identified for the graft HA stenosis. Treatment methods included resection of the stenotic segment with primary reanastomosis (n = 17), aortohepatic iliac artery graft (n = 11), interposition vein graft (n = 4), vein patch angioplasty (n = 2), interposition artery graft (n = 1), and percutaneous transluminal balloon angioplasty (n = 6). Postrevisional HA patency was demonstrated in 32 (78%) cases. At a median follow-up of 25 months, 26 patients (67%) were asymptomatic with good liver function. Nine patients had developed biliary strictures. Seven patients had undergone retransplantation and 8 patients had died. The actuarial patient and graft survivals at 4 years in the patients with revised HA were 65% and 58%, respectively. HA stenosis requiring revision is an infrequent occurrence after OLT. Long-term patency of the revised HA is good. Revision of the HA may help prevent biliary strictures and allow for good long-term graft function in the majority of patients.

Original languageEnglish (US)
Pages (from-to)250-255
Number of pages6
JournalTransplantation
Volume63
Issue number2
DOIs
StatePublished - Jan 27 1997
Externally publishedYes

Fingerprint

Hepatic Artery
Liver Transplantation
Pathologic Constriction
Incidence
Therapeutics
Transplants
Graft Survival
Angioplasty
Veins
Balloon Angioplasty
Iliac Artery
Allografts

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Abbasoglu, O., Levy, M. F., Vodapally, M. S., Goldstein, R. M., Husberg, B. S., Gonwa, T. A., & Klintmalm, G. B. (1997). Hepatic artery stenosis after liver transplantation - Incidence, presentation, treatment, and long term outcome. Transplantation, 63(2), 250-255. https://doi.org/10.1097/00007890-199701270-00013

Hepatic artery stenosis after liver transplantation - Incidence, presentation, treatment, and long term outcome. / Abbasoglu, Osman; Levy, Marlon F.; Vodapally, Mohan S.; Goldstein, Robert M.; Husberg, Bo S.; Gonwa, Thomas A.; Klintmalm, Goran B.

In: Transplantation, Vol. 63, No. 2, 27.01.1997, p. 250-255.

Research output: Contribution to journalArticle

Abbasoglu, O, Levy, MF, Vodapally, MS, Goldstein, RM, Husberg, BS, Gonwa, TA & Klintmalm, GB 1997, 'Hepatic artery stenosis after liver transplantation - Incidence, presentation, treatment, and long term outcome', Transplantation, vol. 63, no. 2, pp. 250-255. https://doi.org/10.1097/00007890-199701270-00013
Abbasoglu, Osman ; Levy, Marlon F. ; Vodapally, Mohan S. ; Goldstein, Robert M. ; Husberg, Bo S. ; Gonwa, Thomas A. ; Klintmalm, Goran B. / Hepatic artery stenosis after liver transplantation - Incidence, presentation, treatment, and long term outcome. In: Transplantation. 1997 ; Vol. 63, No. 2. pp. 250-255.
@article{239eec3253f944b2af021692ee34eb6e,
title = "Hepatic artery stenosis after liver transplantation - Incidence, presentation, treatment, and long term outcome",
abstract = "Little is known about hepatic artery (HA) patency and patient clinical course when the nonthrombosed HA has been revised. We undertook this study to evaluate the risk factors in the development of HA stenosis and to assess the impact of HA revision on the outcome. A total of 857 adult consecutive OLT in 780 patients performed over a 6-year period were studied. Patients who underwent revision of their nonthrombosed but stenotic HA were reviewed for patient/graft survival, method of HA revision, incidence of biliary strictures, and long-term HA patency. Overall 39 patients (5{\%}) with 41 allografts underwent HA revision for stenosis. Median time to diagnosis was 100 days posttransplant (range 1-1220 days). HA flow at the time of OLT was found to be the only significant variable of an anastomotic stenosis. No risk factor could be identified for the graft HA stenosis. Treatment methods included resection of the stenotic segment with primary reanastomosis (n = 17), aortohepatic iliac artery graft (n = 11), interposition vein graft (n = 4), vein patch angioplasty (n = 2), interposition artery graft (n = 1), and percutaneous transluminal balloon angioplasty (n = 6). Postrevisional HA patency was demonstrated in 32 (78{\%}) cases. At a median follow-up of 25 months, 26 patients (67{\%}) were asymptomatic with good liver function. Nine patients had developed biliary strictures. Seven patients had undergone retransplantation and 8 patients had died. The actuarial patient and graft survivals at 4 years in the patients with revised HA were 65{\%} and 58{\%}, respectively. HA stenosis requiring revision is an infrequent occurrence after OLT. Long-term patency of the revised HA is good. Revision of the HA may help prevent biliary strictures and allow for good long-term graft function in the majority of patients.",
author = "Osman Abbasoglu and Levy, {Marlon F.} and Vodapally, {Mohan S.} and Goldstein, {Robert M.} and Husberg, {Bo S.} and Gonwa, {Thomas A.} and Klintmalm, {Goran B.}",
year = "1997",
month = "1",
day = "27",
doi = "10.1097/00007890-199701270-00013",
language = "English (US)",
volume = "63",
pages = "250--255",
journal = "Transplantation",
issn = "0041-1337",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Hepatic artery stenosis after liver transplantation - Incidence, presentation, treatment, and long term outcome

AU - Abbasoglu, Osman

AU - Levy, Marlon F.

AU - Vodapally, Mohan S.

AU - Goldstein, Robert M.

AU - Husberg, Bo S.

AU - Gonwa, Thomas A.

AU - Klintmalm, Goran B.

PY - 1997/1/27

Y1 - 1997/1/27

N2 - Little is known about hepatic artery (HA) patency and patient clinical course when the nonthrombosed HA has been revised. We undertook this study to evaluate the risk factors in the development of HA stenosis and to assess the impact of HA revision on the outcome. A total of 857 adult consecutive OLT in 780 patients performed over a 6-year period were studied. Patients who underwent revision of their nonthrombosed but stenotic HA were reviewed for patient/graft survival, method of HA revision, incidence of biliary strictures, and long-term HA patency. Overall 39 patients (5%) with 41 allografts underwent HA revision for stenosis. Median time to diagnosis was 100 days posttransplant (range 1-1220 days). HA flow at the time of OLT was found to be the only significant variable of an anastomotic stenosis. No risk factor could be identified for the graft HA stenosis. Treatment methods included resection of the stenotic segment with primary reanastomosis (n = 17), aortohepatic iliac artery graft (n = 11), interposition vein graft (n = 4), vein patch angioplasty (n = 2), interposition artery graft (n = 1), and percutaneous transluminal balloon angioplasty (n = 6). Postrevisional HA patency was demonstrated in 32 (78%) cases. At a median follow-up of 25 months, 26 patients (67%) were asymptomatic with good liver function. Nine patients had developed biliary strictures. Seven patients had undergone retransplantation and 8 patients had died. The actuarial patient and graft survivals at 4 years in the patients with revised HA were 65% and 58%, respectively. HA stenosis requiring revision is an infrequent occurrence after OLT. Long-term patency of the revised HA is good. Revision of the HA may help prevent biliary strictures and allow for good long-term graft function in the majority of patients.

AB - Little is known about hepatic artery (HA) patency and patient clinical course when the nonthrombosed HA has been revised. We undertook this study to evaluate the risk factors in the development of HA stenosis and to assess the impact of HA revision on the outcome. A total of 857 adult consecutive OLT in 780 patients performed over a 6-year period were studied. Patients who underwent revision of their nonthrombosed but stenotic HA were reviewed for patient/graft survival, method of HA revision, incidence of biliary strictures, and long-term HA patency. Overall 39 patients (5%) with 41 allografts underwent HA revision for stenosis. Median time to diagnosis was 100 days posttransplant (range 1-1220 days). HA flow at the time of OLT was found to be the only significant variable of an anastomotic stenosis. No risk factor could be identified for the graft HA stenosis. Treatment methods included resection of the stenotic segment with primary reanastomosis (n = 17), aortohepatic iliac artery graft (n = 11), interposition vein graft (n = 4), vein patch angioplasty (n = 2), interposition artery graft (n = 1), and percutaneous transluminal balloon angioplasty (n = 6). Postrevisional HA patency was demonstrated in 32 (78%) cases. At a median follow-up of 25 months, 26 patients (67%) were asymptomatic with good liver function. Nine patients had developed biliary strictures. Seven patients had undergone retransplantation and 8 patients had died. The actuarial patient and graft survivals at 4 years in the patients with revised HA were 65% and 58%, respectively. HA stenosis requiring revision is an infrequent occurrence after OLT. Long-term patency of the revised HA is good. Revision of the HA may help prevent biliary strictures and allow for good long-term graft function in the majority of patients.

UR - http://www.scopus.com/inward/record.url?scp=0030899008&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030899008&partnerID=8YFLogxK

U2 - 10.1097/00007890-199701270-00013

DO - 10.1097/00007890-199701270-00013

M3 - Article

VL - 63

SP - 250

EP - 255

JO - Transplantation

JF - Transplantation

SN - 0041-1337

IS - 2

ER -