Bommena et al reported features of hepatic artery stenosis after liver transplantation. Hepatic artery stenosis is a significant finding that requires aggressive management. The authors are from the University of Arizona.
Patient selection: recipient status post liver transplant
Criteria for hepatic artery stenosis - one or more of the following:
(1) main hepatic artery resistive index < 0.5 on Doppler ultrasonography
(2) peak systolic velocity > 200 cm/second on Doppler ultrasonography
(3) presence of tardus parvus waveforms on Doppler ultrasonography
(4) >= 50% narrowing of hepatic artery luminal diameter in multidetector CT angiography
Risk factors for hepatic artery stenosis:
(1) donation after cardiac death
(2) variation in donor hepatic arteries requiring complex reconstruction
(3) biliary stricture (also said to be a complication)
Complications associated with hepatic artery stenosis:
(1) worse graft survival
(2) hepatic artery thrombosis
(3) worse overall survival
