Preoperative transarterial chemoembolization does not increase hepatic artery complications after liver transplantation: A single center 12-year experience

详细信息    查看全文

• 作者：Hongyu Li ; Bo Li ; ^{doclibo@126.com" class="auth_mail" title="E-mail the corresponding author} ; Yonggang Wei ; Lvnan Yan ; Tianfu Wen ; Wentao Wang ; Jiayin Yang ; Wusheng Lu ; Mingqing Xu
• 关键词：HAC ; hepatic artery complications ; TACE ; transarterial chemoembolization ; HA ; hepatic artery ; OLT ; orthotopic liver transplantation ; HCC ; hepatocellular carcinoma ; UCSF ; University of California San Francesco ; MELD ; Model for End-stage Liver Disease ; AFP ; alpha-fetoprotein ; DUS ; Doppler ultrasonography ; RI ; Resistive index ; BMI ; body mass index ; WIT ; warm ischemia time ; CIT ; cold ischemia time ; TIPSS ; transjugular intrahepatic ; Tac ; tacrolimus ; MMF ; mycophenolate mofetil ; CsA ; ciclosporin A
• 刊名：Clinics and Research in Hepatology and Gastroenterology
• 出版年：2015
• 出版时间：September 2015
• 年：2015
• 卷：39
• 期：4
• 页码：451-457
• 全文大小：466 K

文摘

As a bridge to liver transplantation or downstaging therapy for hepatocellular carcinoma (HCC) patients, preoperative transarterial chemoembolization (TACE) has potential risks in causing damage to hepatic artery (HA), resulting in severe postoperative complications.

Aim

To evaluate the impact of pre-TACE on postoperative hepatic artery complications (HAC) for HCC patients in a single liver transplant center.

Materials and methods

Clinical data of 450 HCC patients undergoing orthotopic liver transplantation (OLT) from January 2001 to December 2013 were retrospectively analyzed. Patients were divided into Group 1 (with pre-TACE) and Group 2 (without pre-TACE). Preoperative characteristics and postoperative HAC were compared.

Results

One hundred and eleven patients (69 men; median age, 37 ± 9.9 years) in Group 1 were compared with 339 patients (244 men; median age, 38.8 ± 8.0 years) in Group 2. Patients were comparable in donor/recipients characteristics between groups. Histological review for native liver samples showed that Edema was the most often seen complication following pre-OLT TACE (troncluar: 87 vs 9; segmental: 91 vs 10; liver parenchyma: 93 vs 8; P = 0.000). Fibrosis, thrombosis and aneurysm were only seen in Group 1. There were no significant difference in postoperative HAC (5/111 (4.5%) vs 5/339 (1.5%), P = 0.131) between groups.

Conclusion

Our single institution experience showed that it might be safe to perform pre-TACE in HCC patients before OLT. It would not increase postoperative HAC risk.