Surgical Versus Image-Guided Interventions in the Management of Complications After Liver Transplantation

Tech Vasc Interv Radiol. 2023 Dec;26(4):100922. doi: 10.1016/j.tvir.2023.100922. Epub 2023 Oct 22.

Abstract

Liver transplantation is a technically demanding surgical procedure with known complications, and the optimal approach to addressing vascular and biliary complications requires a coordinated effort between surgical and interventional radiology teams. Vascular complications involving the hepatic artery, portal vein, or hepatic veins can be characterized by their mechanism, chronicity, and timing of presentation. These factors help determine whether the optimal therapeutic approach is surgical or endovascular. Very early presentation in the perioperative period favors surgical revision, while later presentation is best addressed endovascularly. Biliary complications can be categorized as leaks or strictures, and coordinated surgical, endoscopic, and percutaneous management is needed to address these types of complications. Through advances in technique and the management of complications, outcomes after liver transplantation continue to improve.

Keywords: biliary stricture; hepatic artery thrombosis; liver transplantation; portal vein thrombosis; vascular complications.

MeSH terms

  • Biliary Tract Diseases* / therapy
  • Hepatic Artery
  • Humans
  • Liver Transplantation* / adverse effects
  • Portal Vein / diagnostic imaging
  • Portal Vein / surgery
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / etiology
  • Postoperative Complications / therapy
  • Retrospective Studies