TY - JOUR
T1 - Treatment strategies for hepatic artery complications after pediatric liver transplantation
T2 - A systematic review
AU - Li, Weihao
AU - Bokkers, Reinoud P.H.
AU - Dierckx, Rudi A.J.O.
AU - Verkade, Henkjan J.
AU - Sanders, Dewey H.
AU - Kleine, Ruben de
AU - van der Doef, Hubert P.J.
N1 - Copyright © 2023 American Association for the Study of Liver Diseases.
PY - 2024/2/1
Y1 - 2024/2/1
N2 - This study aimed to evaluate the effectiveness of different treatments for hepatic artery thrombosis (HAT) and hepatic artery stenosis (HAS) after pediatric liver transplantation. We systematically reviewed studies published since 2000 that investigated the management of HAT and/or HAS after pediatric liver transplantation. Studies with a minimum of 5 patients in one of the treatment methods were included. The primary outcomes were technical success rate and graft and patient survival. The secondary outcomes were hepatic artery patency, complications, and incidence of HAT and HAS. Of 3570 studies, we included 19 studies with 328 patients. The incidence was 6.2% for HAT and 4.1% for HAS. Patients with an early HAT treated with surgical revascularization had a median graft survival of 45.7% (interquartile range, 30.7%-60%) and a patient survival of 61.3% (interquartile range, 58.7%-66.9%) compared with the other treatments (conservative, endovascular revascularization, or retransplantation). As for HAS, endovascular and surgical revascularization groups had a patient survival of 85.7% and 100% (interquartile range, 85%-100%), respectively. Despite various treatment methods, HAT after pediatric liver transplantation remains a significant issue that has profound effects on the patient and graft survival. Current evidence is insufficient to determine the most effective treatment for preventing graft failure.
AB - This study aimed to evaluate the effectiveness of different treatments for hepatic artery thrombosis (HAT) and hepatic artery stenosis (HAS) after pediatric liver transplantation. We systematically reviewed studies published since 2000 that investigated the management of HAT and/or HAS after pediatric liver transplantation. Studies with a minimum of 5 patients in one of the treatment methods were included. The primary outcomes were technical success rate and graft and patient survival. The secondary outcomes were hepatic artery patency, complications, and incidence of HAT and HAS. Of 3570 studies, we included 19 studies with 328 patients. The incidence was 6.2% for HAT and 4.1% for HAS. Patients with an early HAT treated with surgical revascularization had a median graft survival of 45.7% (interquartile range, 30.7%-60%) and a patient survival of 61.3% (interquartile range, 58.7%-66.9%) compared with the other treatments (conservative, endovascular revascularization, or retransplantation). As for HAS, endovascular and surgical revascularization groups had a patient survival of 85.7% and 100% (interquartile range, 85%-100%), respectively. Despite various treatment methods, HAT after pediatric liver transplantation remains a significant issue that has profound effects on the patient and graft survival. Current evidence is insufficient to determine the most effective treatment for preventing graft failure.
KW - Humans
KW - Child
KW - Hepatic Artery/surgery
KW - Liver Transplantation/adverse effects
KW - Retrospective Studies
KW - Liver Diseases/etiology
KW - Thrombosis/epidemiology
U2 - 10.1097/LVT.0000000000000257
DO - 10.1097/LVT.0000000000000257
M3 - Article
C2 - 37698924
SN - 1527-6465
VL - 30
SP - 160
EP - 169
JO - Liver Transplantation
JF - Liver Transplantation
IS - 2
ER -