What is the prevalence and cause of hepatic artery stenosis (HAS) following whole-liver orthotopic liver transplantation (OLTX)?

Updated: Nov 11, 2019
  • Author: Fazal Hussain, MD, MPH; Chief Editor: John Karani, MBBS, FRCR  more...
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Answer

Answer

HAS occurs in approximately 11-13% of OLTXs. [26] HAS can be caused by clamp injury, intimal injury due to perfusion catheters, anastomotic ischemia due to a disrupted vasa vasorum, and rejection. The consequences of hemodynamically significant HAS (>50% stenosis) are essentially identical to those of HAT. Although a few stenoses have been corrected with balloon angioplasty, HAS, similar to HAT, usually requires operative vascular reconstruction or retransplantation (see the images below).

A-4: Digital subtraction angiogram depicts redunda A-4: Digital subtraction angiogram depicts redundant donor-recipient hepatic artery. A stenotic hairpin turn is noted.
A-5: Digital subtraction angiogram obtained during A-5: Digital subtraction angiogram obtained during balloon angioplasty of a stenotic artery.
A-6: Digital subtraction angiogram shows a widely A-6: Digital subtraction angiogram shows a widely patent hepatic artery after angioplasty.

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