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Prognostic significance of hepatic arterial collaterals in liver transplant recipients with biliary strictures
Author(s) -
Viveiros André,
Rehwald Rafael,
Vettori Erich,
Finkenstedt Armin,
Effenberger Maria,
Schaefer Benedikt,
Dorn Livia,
Tilg Herbert,
Schneeberger Stefan,
Glodny Bernhard,
Zoller Heinz,
Freund Martin C.
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12881
Subject(s) - medicine , anastomosis , artery , liver transplantation , stenosis , gastroenterology , bile duct , pathological , radiology , surgery , transplantation
Abstract Background The aim of this study was to determine the prevalence of hepatic artery stenosis ( HAS ) and the prognostic implications of hepatic arterial collaterals in liver transplant ( LT ) recipients with biliary strictures. Methods The 105 LT recipients transplanted between 2004 and 2015 at our center had documented biliary strictures. HAS and collaterals were assessed in high‐quality imaging of the hepatic artery available from 66 recipients. Clinical, demographic, and biochemical recipient and donor data were retrospectively analyzed and tested for their association with biliary or arterial complications after LT . Results The prevalence of HAS was 68% (45 of 66) in LT recipients with biliary strictures. Seventy‐six percent (37 of 49) of patients with nonanastomotic biliary strictures had HAS . This was significantly higher than in patients with anastomotic stricture, where 47% (8 of 17) of patients had a pathological hepatic arteriogram ( P =.039). The location of bile duct strictures was not predictive for outcome. In contrast, arterial collaterals were associated with significantly better patient and graft survival. Conclusion Impaired hepatic arterial perfusion is frequently associated with nonanastomotic strictures, but less closely correlated with anastomotic strictures. On survival analysis, hepatic arterial collaterals have a protective effect.