Vascular complications following liver transplantation: A literature review of advances in 2015

Abstract

Although vascular complications (VCs) following orthotopic liver transplantation (OLT) seldom occur, they are the most feared complications with a high incidence of both graft loss and mortality, as they compromise the blood flow of the transplant (either inflow or outflow). Diagnosis and therapeutic management of VCs constitute a major challenge in terms of increasing the success rate of liver transplantation. While surgical treatment used to be considered the first choice for management, advances in endovascular intervention have increased to make this a viable therapeutic option. Considering VC as a rare but a major and dreadful issue in OLT history, and in view of the continuing and rapid progress in recent years, an update on these uncommon conditions seemed necessary. In this sense, this review comprehensively discusses the important features (epidemiological, clinical, paraclinical, prognostic and therapeutic) of VCs following OLT.

Keywords: Endovascular intervention; Liver transplantation; Orthotopic liver transplantation; Vascular complications.

Figure 1

Contrast-enhanced-multidetector-row computed tomography-scan showing hepatic artery thrombosis after an endovascular intervention with stent placement. Thrombus (arrow).

Figure 2

Arteriography showing an anastomotic hepatic artery stenosis after orthotopic liver transplantation. Stenosis (arrow).

Figure 3

Contrast-enhanced-multidetector-row computed tomography-scan showing a hepatic artery pseudoaneurysm following orthotopic liver transplantation. Pseudoaneurysm (arrow).

Figure 4

Arteriography showing a hepatic artery stenosis due to a kinking following orthotopic liver transplantation. Kinking stenosis (arrow).

Figure 5

Contrast-enhanced-multidetector-row computed tomography-scan showing median and left thromboses hepatic veins following orthotopic liver transplantation (arrow).