Vascular and biliary complications after liver transplantation: interventional treatment.
OBJECTIVE
To evaluate the value of angiography and cholangiography on the diagnosis and interventional treatment of vascular and biliary complications after liver transplantation.


METHODS
Sixteen of 46 patients (15 men and 1 woman, 17 - 60 years old) after orthotopic liver transplantation received angiography due to abnormal ultrasonography or edema of lower limbs, or cholangiography due to progressing jaundice. Percutaneous transluminal angioplasty or drainage was performed in some patients.


RESULTS
Fifteen patients experienced vascular complications and 4 patients had biliary complications. Three of them appeared to have both vascular and biliary complications. Hepatic artery complications were the most common complications (9/16), including hepatic artery thrombosis or stenosis (6/9), bleeding (2/9) and hepatic artery-dissecting aneurysm (1/9). One patient with hepatic artery thrombosis received transcatheter thrombolysis and two patients with bleeding received coil embolization. Inferior vena cava and portal vein stenosis were observed in 6 and 2 patients, respectively. After balloon angioplasty or stent placement, clinical symptoms were alleviated. Biliary complications, including biliary stricture and anastomotic bile leak, occurred in 4 patients. Jaundice decreased after percutaneous transhepatic cholangiography and drainage.


CONCLUSIONS
Besides diagnosis, interventional methods include mini-invasive treatment for patients with vascular and biliary complications after liver transplantation. Balloon angiography and stent placement for venous stenosis are useful procedure for the treatment of these problems.
Jiang
Li
L
Department of Radiology, First Affiliated Hospital of Sun Yat-Sen University of Medical Sciences, Guangzhou 510080, China. lxjiang@gzsums.edu.cn
Yang
Jianyong
J
Chen
Wei
W
Zhuang
Wenquan
W
D000293:Adolescent; D000328:Adult; D001660:Biliary Tract Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D002758:Cholangiography; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging; D014652:Vascular Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging