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 Baker, Laura M Kulik, Juan C Caicedo, Riad Salem, Robert J Lewandowski*

*Corresponding author for this work

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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

Fingerprint

Liver Transplantation
Liver
Hepatocellular Carcinoma
Hepatic Artery
Thrombosis
Therapeutics
Transplants
Yttrium
Chi-Square Distribution
Control Groups
Incidence

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

Cite this

@article{606cff2dbf36425cb338ea8cc4307eb5,
title = "Pretransplant Intra-arterial Liver-Directed Therapy Does Not Increase the Risk of Hepatic Arterial Complications in Liver Transplantation: A Single-Center 10-Year Experience",
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.",
keywords = "Conduit, Hepatic arterial thrombosis, Intra-arterial therapies, Orthotopic liver transplant, RE), Transarterial chemoembolization (TACE), Transarterial radioembolization (TARE, Yttrium-90 (Y, Y90)",
author = "Kallini, {Joseph R.} and Ahmed Gabr and Rehan Ali and Nadine Abouchaleh and Ahsun Riaz and Talia Baker and Kulik, {Laura M} and Caicedo, {Juan C} and Riad Salem and Lewandowski, {Robert J}",
year = "2018",
month = "2",
day = "1",
doi = "10.1007/s00270-017-1793-z",
language = "English (US)",
volume = "41",
pages = "231--238",
journal = "CardioVascular and Interventional Radiology",
issn = "7415-5101",
publisher = "Springer Verlag",
number = "2",

}

TY - JOUR

T1 - Pretransplant Intra-arterial Liver-Directed Therapy Does Not Increase the Risk of Hepatic Arterial Complications in Liver Transplantation

T2 - A Single-Center 10-Year Experience

AU - Kallini, Joseph R.

AU - Gabr, Ahmed

AU - Ali, Rehan

AU - Abouchaleh, Nadine

AU - Riaz, Ahsun

AU - Baker, Talia

AU - Kulik, Laura M

AU - Caicedo, Juan C

AU - Salem, Riad

AU - Lewandowski, Robert J

PY - 2018/2/1

Y1 - 2018/2/1

N2 - 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.

AB - 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.

KW - Conduit

KW - Hepatic arterial thrombosis

KW - Intra-arterial therapies

KW - Orthotopic liver transplant

KW - RE)

KW - Transarterial chemoembolization (TACE)

KW - Transarterial radioembolization (TARE

KW - Yttrium-90 (Y, Y90)

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U2 - 10.1007/s00270-017-1793-z

DO - 10.1007/s00270-017-1793-z

M3 - Article

C2 - 28900709

AN - SCOPUS:85029173295

VL - 41

SP - 231

EP - 238

JO - CardioVascular and Interventional Radiology

JF - CardioVascular and Interventional Radiology

SN - 7415-5101

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ER -