Title: Treatment strategies of hepatic artery complications after pediatric liver transplantation: a systematic review
Source: Liver Transplantation 2023, Sept 13. [E–publication]
Date of publication: September 2023
Publication type: Systematic review
Abstract: Objectives: This study aimed to evaluate the effectiveness of different treatments for hepatic artery thrombosis (HAT) and hepatic artery stenosis (HAS) after pediatric liver transplantation (pLT).
Methods: We systematically reviewed studies published since 2000 that investigated the management of HAT and/or HAS after pLT. Studies with a minimum of 5 patients in one of the treatments 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.
Results: 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 [IQR], 30.7%-60%) and a patient survival of 61.3% (IQR, 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% (IQR, 85%-100%), respectively.
Conclusions: Despite various treatment methods, HAT after pLT remains a significant issue that has profound effects on the patient and graft survivals. Current evidence is insufficient to determine the most effective treatment for preventing graft failure.
