Endovascular Treatment for Very Early Hepatic Artery Stenosis Following Living-Donor Liver Transplantation: Report of Two Cases

Some literature has reported on endovascular treatment for very early hepatic artery stenosis (HAS; within 2 weeks after liver transplantation, and has deemed endovascular treatment to be a contraindication because out of serious complications associated with the procedure. We report on 2 cases of v...

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Bibliographic Details
Published in:Transplantation proceedings 2018-06, Vol.50 (5), p.1457-1460
Main Authors: Goto, Y., Shirahama, N., Sasaki, S., Kawahara, R., Sakai, H., Ishikawa, H., Hisaka, T., Ogata, T., Yasunaga, M., Akagi, Y., Tanaka, H., Okuda, K.
Format: Article
Language:English
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Summary:Some literature has reported on endovascular treatment for very early hepatic artery stenosis (HAS; within 2 weeks after liver transplantation, and has deemed endovascular treatment to be a contraindication because out of serious complications associated with the procedure. We report on 2 cases of very early HAS successfully treated with endovascular treatment after living-donor liver transplantation (LDLT). A 54-year-old woman underwent LDLT with a left liver graft. The native right gastric artery and left hepatic artery (LHA) of the donor were anastomosed. On postoperative day (POD) 13, HAS was suspected and multidetector computerized tomographic angiography (MDCTA) was performed, which revealed 90% stenosis of the arterial anastomosis and 50% stenosis of the LHA in the graft. We performed percutaneous balloon arterioplasty (PBA) without any complications. The artery was patent with a postoperative follow-up of 60 months without the need for repeat intervention. A 67-year-old woman with a history of repeated transarterial chemoembolization for hepatocellular carcinoma underwent LDLT with a left liver graft. The native A4 and LHA of the donor were anastomosed. We performed MDCTA on POD 11, which revealed 70% stenosis of the native hepatic artery. We performed PBA followed by stent placement on POD 11 without complication. The artery was patent with a postoperative follow-up of 40 months without the need for repeated intervention. Endovascular treatment has the potential to avoid the need for repeated surgical interventions or retransplantation, and it can be safely performed in carefully selected patients. •Some literature has reported endovascular treatment to be contraindicated for hepatic artery stenosis in the early postoperative periods.•We defined hepatic artery stenosis within 2 weeks after liver transplantation as “very early hepatic artery stenosis.”•We successfully performed endovascular therapy for very early postoperative hepatic artery stenosis.•Endovascular strategy for very early hepatic artery stenosis has the potential to avoid additional surgical interventions.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2018.02.074