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

Updated: Mar 01, 2019
  • Author: Paul D Russ, MD; Chief Editor: John Karani, MBBS, FRCR  more...
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Answer

Answer

HAS occurs in approximately 11-13% of OLTXs. [25] 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).

Digital subtraction angiogram depicts redundant do Digital subtraction angiogram depicts redundant donor-recipient hepatic artery. A stenotic hairpin turn is noted.
Digital subtraction angiogram obtained during ball Digital subtraction angiogram obtained during balloon angioplasty of a stenotic artery.
Digital subtraction angiogram shows a widely paten Digital subtraction angiogram shows a widely patent hepatic artery after angioplasty.

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