Risk of Hepatic Artery Complications After Liver Transplantation in Patients Who Received Pretransplant Transarterial Chemoembolization Therapy: A Single-Center Experience |
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| Institution: | 1. Division of Transplant Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin;2. Department of Radiology, Division of Vascular and Interventional Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin;3. Division of Transplantation, Department of Surgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania;1. Division of Abdominal Transplantation, The Comprehensive Transplant Center, Department of General Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio;2. Division of Nephrology, The Comprehensive Transplant Center, The Ohio State University Wexner Medical Center, Columbus, Ohio;1. Hospital Israelita Albert Einstein, São Paulo, Brazil;2. Federal University of São Paulo, São Paulo, Brazil;1. Bahçelievler Memorial Hospital, Organ Transplantation Center, Istanbul, Turkey;2. Bahçelievler Memorial Hospital, Department of Gastroenterology, Istanbul, Turkey;1. Department of Medical Oncology, the First Medical Centre, Chinese People''s Liberation Army General Hospital, Beijing, China;2. Outpatient Department, Jingnan Medical Area, Chinese People''s Liberation Army General Hospital, Beijing, China;3. Thoracic Surgery, the Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People''s Hospital, Qingyuan, China;4. Medical School of Chinese People''s Liberation Army, Beijing, China;5. Department of Radiology, 82 Group Hospital of Chinese People''s Liberation Army, Baoding, China |
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| Abstract: | BackgroundPretransplant transarterial chemoembolization (TACE) for patients with hepatocellular carcinoma (HCC) has been associated with an increased risk of hepatic artery thrombosis (HAT) after liver transplantation (LT). Innovative surgical LT and interventional vascular radiology TACE techniques may mitigate the risk of HAT. We sought to investigate the incidence of HAT after LT in patients who received pre-transplant TACE at our center.MethodsWe performed a single-center retrospective review of all LT patients, >18 years of age, from October 1, 2012, to May 31, 2018. Outcomes were compared between patients who received pre-LT TACE and those who did not. Median follow-up was 26 months.ResultsAmong the 162 LT recipients, 110 (67%) patients did not receive pre-LT TACE (Group I), while 52 (32%) received pre-LT TACE (Group II). The <30-day incidence rates of post-LT HAT were as follows: Group I = 1.8% and Group II = 1.9% (P = .9). Most hepatic arterial complications occurred >30 days after LT. Based on competing risks regression analysis, TACE was not associated with an increased risk of HAT. Patient or graft survivals were comparable between the 2 groups (P = .1 and .2, respectively).ConclusionsOur study shows a similar incidence of hepatic artery complications post-LT in patients who received TACE before LT compared with those who did not. In addition, we suggest that the surgical technique of early vascular control of the common hepatic artery during LT, in combination with a super-selective vascular intervention radiology approach, has clinical utility in reducing the risk of HAT in patients requiring pre-transplant TACE. |
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