title: Hepatic artery complications following liver transplantation. Does preoperative chemoembolization impact the postoperative course?
abstract: BACKGROUND
  Transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC) may cause damage to the hepatic artery (HA) and impact the postoperative course of the liver transplantation (LT). We aim to describe the relationship between preoperative TACE and the occurrence of histological and radiological hepatic artery complications (HAC).
  
  
  METHODS
  All cirrhotic patients with HCC undergoing LT between January 2009 and October 2012 were included and divided in two groups: TACE (group 1) and No TACE (group 2). HA histological complications were reviewed and compared.
  
  
  RESULTS
  Sixty-seven patients were reviewed, 32 in group 1 and 35 in group 2. Both groups were similar in gender, age, cirrhosis origin, and American Society of Anesthesiology (ASA) score. After a mean follow-up of 17 months, 10 radiological HAC occurred: seven in group 1 and three in group 2 (p = 0.02). There was one thrombosis in each group: six non-thrombotic complications in group 1 and two in group 2. Histological screening showed 12 HA injuries in group 1 (three HA wall edemas, five fibrosis, one edema + fibrosis, one hemorragic necrosis + thrombosis, two thrombosis) and three in group 2 (two HA wall edemas, one fibrosis) (p = 0.01). All these injuries were found at the proper HA and at the right/left HA bifurcation level.
  
  
  CONCLUSIONS
  Despite the limits of our study, we found a higher incidence of radiological and histological injury in patients underwent TACE.
authors.affiliation: Department of General and Liver Transplant Surgery, University of Montpellier, Hôpital Saint Eloi, Montpellier-Cedex 5, France.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Panaro
authors.forename: Jeanne
authors.initials: J
authors.lastname: Ramos
authors.forename: Benoit
authors.initials: B
authors.lastname: Gallix
authors.forename: Grégoire
authors.initials: G
authors.lastname: Mercier
authors.forename: Astrid
authors.initials: A
authors.lastname: Herrero
authors.forename: Halidou
authors.initials: H
authors.lastname: Niampa
authors.forename: Georges-Philippe
authors.initials: GP
authors.lastname: Pageaux
authors.forename: Francis
authors.initials: F
authors.lastname: Navarro
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000628:therapy; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000009:adverse effects*; D006499:Hepatic Artery / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000628:therapy; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
keywords: artery; complications; hepatocellular carcinoma; liver transplantation; transarterial chemoembolization