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HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION LTX: SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS.

HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION (LTX): SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS. . Hepatic artery complications after liver transplantation are uncommon- improved techniques.However, they represent an important cause of morbidity and mortality and are a m

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HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION LTX: SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS.

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    1. HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION (LTX): SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS. Duraid Younan, Randeep kashyap, Peter Abt, Kerrie Lansing, Ashokkumar Jain, Parvez Mantry, Mark Orloff, Adel Bozorgzadeh,

    2. HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION (LTX): SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS. Hepatic artery complications after liver transplantation are uncommon- improved techniques. However, they represent an important cause of morbidity and mortality and are a major indication for retransplantation Hepatic artery stenosis (HAS) reported in 5%13% after orthotopic liver transplantation (LTx) is of significant concern and has been speculated to progress to HAT.

    3. HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION (LTX): SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS. Aim To examine the incidence, clinical presentation, management, and outcome of hepatic artery stenosis.

    4. HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION (LTX): SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS. METHOD From January 1999 to March 2004, a total of 527 patients underwent LTx. Mean age 52.2+10.2 yrs, (M 340;F 187). All patients were followed up until June 2004. Mean follow-up 28+ 15 months.

    5. HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION (LTX): SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS. RESULTS HAS after LTx was observed in 30 cases, resulting in an overall incidence of 5.7%. Mean time to HAS, 126 days or 4.2 months Early HAS (within the first 30 days after LTx) occurred in 5 of these patients (15%), In 25 patients (85%) HAS detected beyond 30 days.

    6. Diagnosis of HAS was based on patients clinical presentation and resistive indexes (RIs) of less than 0.5 on Doppler US Confirmed by angiography if there was an arterial diameter reduction of at least 50%. HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION (LTX): SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS.

    7. HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION (LTX): SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS. CLINICAL PRESENTATION 19(63.3%) patients had Increase in serum transaminases 11(36.7%) diagnosed based on Ultrasound 7 (23.3%) done as part of follow-up. 2 (6.7%) had fluid collection 2 (6.7%) had fever

    8. HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION (LTX): SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS.

    9. HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION (LTX): SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS.

    10. HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION (LTX): SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS.

    11. HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION (LTX): SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS. MANAGEMENT 15 patients (50%) underwent balloon angioplasty, 9/15 patients showed radiological improvement.

    12. HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION (LTX): SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS.

    13. HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION (LTX): SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS. MANAGEMENT In 6 patients angioplasty did not help subsequently underwent a surgical revision 3 for failed PTA without complications, 2 for complications after PTA, one for restenosis) one underwent retransplantation after hepatic artery rupture

    14. HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION (LTX): SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS. MANAGEMENT 8(26.7%), were primarily treated with open surgical repair without previous hepatic artery PTA. Stenosis resolved in 6 patients, 1 patient required retransplant and one patient developed restenosis of the hepatic artery.

    15. Long-term patency for PTA and/or surgical revision was based on Doppler US evaluation. A change in the post-PTA RI compared with the pre-PTA RI greater than 0.1 was considered significant based on liver Doppler US studies evaluating hepatic arteries HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION (LTX): SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS.

    16. HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION (LTX): SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS.

    17. HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION (LTX): SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS. At last follow-up 22 patients were alive with functioning grafts. Biliary complications developed in 15 patients. ERCP (N=1) PTC (N=9) Surgical repair (N=8)

    18. HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION (LTX): SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS. CONCLUSION

    19. Thank You

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