Weiße Sebastian, Mostafa Karim, Andersson Julian, Gundlach Jan-Paul, Becker Thomas, Schäfer Jost Philipp, Braun Felix
Department of Internal Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany.
Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Street 3, 24105 Kiel, Germany.
J Clin Med. 2025 Feb 14;14(4):1262. doi: 10.3390/jcm14041262.
: Curative treatment of HCC can be achieved by liver transplantation. In the framework of transplantation, add-on transarterial chemoembolization (TACE) can be performed as bridging therapy for local tumor control. The association between TACE and an increased incidence of hepatic arterial complications after transplantation has been investigated in multiple research items; however, the exact association remains unclear. The aim of this report was to explore the role of pre-transplantation TACE and pre-existing vascular celiac pathologies on the occurrence of postoperative hepatic arterial complications. : This retrospective single-center study included all patients who underwent liver transplantation between 2008 and 2020. Arterial complication was defined as any postoperative occlusion, stenosis >50%, dissection or aneurysm on cross-sectional imaging. : This study encompasses 109 patients after transplantation, of which 80 underwent TACE prior to transplantation. The overall incidence of postoperative arterial complications did not differ between the groups (TACE 8/80 vs. control 6/29, = 0.19). Further analysis showed no significant differences in the occurrence of specific complications (Occlusion: TACE 9/80 vs. control 3/29, = 0.56; Stenosis: TACE 4/80 vs. control 5/29, = 0.05; Dissection: TACE 1/80 vs. control 1/29; = 0.46). Furthermore, linear regression analysis for preoperative TACE therapy, anatomic variants and pre-existing pathologies of the hepatic vasculature showed no association with postoperative arterial complications. : Preoperative TACE therapy showed no influence on the incidence of post-transplant arterial complications in patients after liver transplantation. Furthermore, preoperative TACE therapy as well as anatomic variants and pre-existing arterial pathologies of the celiac axis could not be identified as risk factors for complications at the arterial anastomotic site after transplantation.
肝癌的根治性治疗可通过肝移植实现。在移植框架内，可进行经动脉化疗栓塞术（TACE）作为局部肿瘤控制的桥接治疗。多项研究项目对TACE与移植后肝动脉并发症发生率增加之间的关联进行了研究；然而，确切关联仍不明确。本报告的目的是探讨移植前TACE和已存在的腹腔血管病变对术后肝动脉并发症发生的作用。
本回顾性单中心研究纳入了2008年至2020年间接受肝移植的所有患者。动脉并发症定义为横断面成像显示的任何术后闭塞、狭窄>50%、夹层或动脉瘤。
本研究涵盖了109例移植后患者，其中80例在移植前接受了TACE。两组术后动脉并发症的总体发生率无差异（TACE组8/80 vs. 对照组6/29，P = 0.19）。进一步分析显示，特定并发症的发生无显著差异（闭塞：TACE组9/80 vs. 对照组3/29，P = 0.56；狭窄：TACE组4/80 vs. 对照组5/29，P = 0.05；夹层：TACE组1/80 vs. 对照组1/29，P = 0.46）。此外，对术前TACE治疗、肝血管解剖变异和已存在的病变进行线性回归分析，结果显示与术后动脉并发症无关联。
术前TACE治疗对肝移植患者移植后动脉并发症的发生率无影响。此外，术前TACE治疗以及腹腔动脉轴的解剖变异和已存在的动脉病变不能被确定为移植后动脉吻合口并发症的危险因素。
