Pretransplant Intra-arterial Liver-Directed Therapy Does Not Increase the Risk of Hepatic Arterial Complications in Liver Transplantation: A Single-Center 10-Year Experience

Joseph R. Kallini, Ahmed Gabr, Rehan Ali, Nadine Abouchaleh, Ahsun Riaz, Talia Barzel Baker, Laura Kulik, Juan Caicedo, Riad Salem, Robert J. Lewandowski*

*Corresponding author for this work

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Purpose: To investigate the association between pretransplant intra-arterial liver-directed therapy (IAT) for hepatocellular carcinoma (HCC) and hepatic arterial complications (HAC) in orthotopic liver transplantation (OLT) [namely hepatic artery thrombosis (HAT) and/or the need for hepatic arterial conduit]. Methods: A total of 175 HCC patients (mean age: 60 years) underwent IAT with either transarterial chemoembolization or yttrium-90 (90Y) transarterial radioembolization prior to OLT between 2003 and 2013. A matched control cohort of 159 HCC patients who underwent OLT without prior IAT was selected. Incidence of HAC in both cohorts was investigated. The categorical differences between both cohorts were calculated by chi-square test. Results: Among the 175 patients (chemoembolization, n = 82; radioembolization, n = 93), 8 (5%) required conduits due to HA disease (chemoembolization, n = 6; radioembolization, n = 2), 3 (2%) developed HAT (chemoembolization, n = 2; radioembolization, n = 1). Eleven of 175 patients (6.7%) had HAC. Of the 159 control patients, 6 (4%) needed conduits for HA disease and 3 (2%) developed HAT. Nine of 159 patients (5.7%) had HAC. Chi-square analysis between the IAT cohort and the control group yielded a p value of 0.810. When comparing chemoembolization to radioembolization, p = 0.076 (not significant at p < 0.05). Conclusion: Although aggressive pretransplant radioembolization and chemoembolization are both utilized in most liver transplant centers, neither appears to increase the risk of peri-transplant hepatic arterial complications in HCC patients.

Original languageEnglish (US)
Pages (from-to)231-238
Number of pages8
JournalCardiovascular and Interventional Radiology
Volume41
Issue number2
DOIs
StatePublished - Feb 1 2018

Keywords

  • Conduit
  • Hepatic arterial thrombosis
  • Intra-arterial therapies
  • Orthotopic liver transplant
  • RE)
  • Transarterial chemoembolization (TACE)
  • Transarterial radioembolization (TARE
  • Yttrium-90 (Y, Y90)

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Pretransplant Intra-arterial Liver-Directed Therapy Does Not Increase the Risk of Hepatic Arterial Complications in Liver Transplantation: A Single-Center 10-Year Experience'. Together they form a unique fingerprint.

  • Cite this