Abstract No. 113 Primary Stent Placement for Hepatic Artery Stenosis After Liver Transplantation: Improving Primary Patency and Reintervention Rates

To evaluate the outcomes of primary stenting after hepatic artery stenosis (HAS) with long-term follow-up. After institutional review board approval, all patients undergoing liver transplantation between 2002 and 2023 at a single institution were evaluated for HAS. HAS occurred in 71 patients. HAS was defined as >50% stenosis on computed tomography or digital subtraction angiography. Hepatic arterial patency and graft survival were evaluated at annual intervals. Primary patency was defined as the time from revascularization to imaging evidence of new HAS or reaching a censored event (retransplantation, death, loss to follow-up, or end of study period). Continuous variables were reported as median with interquartile range. Primary stenting was performed in 71 transplant patients with HAS (32 females, 45%; median age, 53 (43–64) years). Most common cause of etiology of cirrhosis was Alcoholic (31 [44%]), followed by Viral (13 [18%]) and NASH (8 [11%]). 63 (89%) patients had a single anastomosis whereas 7 (9.86%) patients had more than one anastomosis. Median time from transplant to diagnosis of HAS was 33 (7-99) days. Endovascular treatment was performed within 30 days of the primary anastomosis in 32/71 (45%) of patients. Technical success was accomplished in 100% (71/71) of patients. 41 (58%) patients had a single stent placed, 20 (29%) had 2 stents and 7 (10%) had 3 stents placed. 9 (13%) patients had a drug-eluting stent. Median time of primary patency in 71 patients was 56 months (26–101). Primary patency was 85% at 1 year. Reintervention was required in 17(24%) patients to maintain stent patency. The median time period between primary stenting and retreatment was 34 days (IQR, 19 - 148 days). In conclusion, primary stenting for HAS has excellent long-term primary patency and low reintervention rates.