title: Rescue Arterial Revascularization Using Cryopreserved Iliac Artery Allograft in Liver Transplant Patients.
abstract: OBJECTIVE
  Management of hepatic arterial complications after liver transplant remains challenging. The aim of our study was to assess the efficacy of rescue arterial revascularization using cryopreserved iliac artery allografts in this setting.
  
  
  METHODS
  Medical records of patients with liver transplants who underwent rescue arterial revascularization using cryopreserved iliac artery allografts at a single institution were reviewed.
  
  
  RESULTS
  From 1992 to 2015, 7 patients underwent rescue arterial revascularization using cryopreserved iliac artery allografts for hepatic artery pseudoaneurysm (3 patients), thrombosis (2 patients), aneurysm (1 patient), or stenosis (1 patient). Two patients developed severe complications, comprising one biliary leakage treated percutaneously, and one acute necrotizing pancreatitis causing death on postoperative day 29. After a median follow-up of 75 months (range, 1-269 mo), 2 patients had an uneventful long-term course, whereas 4 patients developed graft thrombosis after a median period of 120 days (range, 2-488 d). Among the 4 patients who developed graft thrombosis, 1 patient developed ischemic cholangitis, 1 developed acute ischemic hepatic necrosis and was retransplanted, and 2 patients did not develop any further complications.
  
  
  CONCLUSIONS
  Despite a high rate of allograft thrombosis, rescue arterial revascularization using cryopreserved iliac artery allografts after liver transplant is an effective and readily available approach, with a limited risk of infection and satisfactory long-term graft and patient survival.
authors.affiliation: Department of General Surgery and Liver Transplantation, Hospices Civils de Lyon, Croix-Rousse University Hospital, Lyon, France.
authors.forename: Kayvan
authors.initials: K
authors.lastname: Mohkam
authors.forename: Benjamin
authors.initials: B
authors.lastname: Darnis
authors.forename: Agnès
authors.initials: A
authors.lastname: Rode
authors.forename: Nathalie
authors.initials: N
authors.lastname: Hetsch
authors.forename: Gregorio
authors.initials: G
authors.lastname: Balbo
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Bourgeot
authors.forename: Salim
authors.initials: S
authors.lastname: Mezoughi
authors.forename: Hassan
authors.initials: H
authors.lastname: Demian
authors.forename: Christian
authors.initials: C
authors.lastname: Ducerf
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Mabrut
mesh_terms: D000328:Adult; D064591:Allografts; D017541:Aneurysm, False / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D003251:Constriction, Pathologic; D015925:Cryopreservation; D005260:Female; D005602:France; D006085:Graft Survival; D006499:Hepatic Artery / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007083:Iliac Artery / Q000637:transplantation*; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016879:Salvage Therapy; D013927:Thrombosis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D058017:Vascular Grafting / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D014654:Vascular Patency