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One-year outcomes of hepatic artery stenosis after pediatric liver transplantation: Results from the international, multicenter HEPATIC registry.

Wei-Hao Li Hermien Hartog J. Minetto M. Dip S. Sierre S. Franchi-Abella Emmanuel Gonzales Florent Guérin Ane M. Andres F. Hernández-Oliveros Esteban Frauca Remacha Catalina Jaramillo L. Bitterfeld Arielle Melen N. Junge U. Baumann N. Richter J. DiNorcia S. Florman J. Seda E. A. da Fonseca C. M. Costa G. Mazariegos K. Soltys R. Yemini M. de Santibañes Victoria Ardiles J. Uño L. Gonsorčíková J. Froněk Šimon Bohuš G. Gupte Khalid Sharif S. McGuirk Denise Aldrian Jonathan Seisenbacher G. Vogel Barbara E. Wildhaber A. Calinescu Alexis Ricoeur Mukesh Kumar S. Agarwal Subhash Gupta Ting-Bo Liang Xue-Li Bai Wei Zhang Paolo Marra L. d'Antiga D. Pinelli M. Beretta Francisca van der Schyff C. T. Ferreira Luiza Nader M. Farina Jesús Quintero Maria Mercadal-Hally J. Molino W. Hardikar Sue Bates Lynette Goh D. Broering D. Raptis K. Marquez Amit A. Shah B. Domenick Michael R. Acord Arti Pawaria Haritha Rajakrishnan Sudhindran Surendran M. Spada L. Monti T. Alterio T. Casswall C. Jorns Martin Delle M. Rajakannu K. Palaniappan M. Rela Riccardo Superina Juan Carlos Caicedo Khaled Z. Dajani Alessandro Parente D. Bigam V. Mali Marion M. Aw Sonal Asthana M. Sakpal Shaik Qadir Hussain Y. Yanagi H. Uchida Ryuji Komine R. Scheenstra R. Dierckx H. V. D. van der Doef R. Bokkers

Oct 2026 · Digestive and Liver Disease · 0 citations · 22 references

Medicine

Abstract

Aim

This study aimed to describe one-year graft and patient survival after hepatic artery stenosis (HAS) following pediatric liver transplantation (pLT), and to explore outcomes by timing of HAS diagnosis and treatment strategy within the HAS cohort.

Methods

Patients who developed HAS after pLT were included as per definition from the HEPATIC registry. The registry contains data from 32 centers across 21 countries over a 20-year period, during which 10,564 primary pLTs were performed. Donor-, recipient-, and transplant-related characteristics were analyzed. The primary outcome was one-year graft and patient survival.

Results

HAS was diagnosed in 1.2% of patients (n = 130; 51% female; median age 4.4 years [IQR 1.4-11.6]), of whom 5% (n = 7) progressed to thrombosis (HAT). One-year graft and patient survival were 93% and 96%, respectively. Management consisted mainly of antithrombotic therapy alone (41.5%) or endovascular therapy (EVT; 41.5%), with no significant difference in one-year graft or patient survival between these approaches. Early HAS (≤21 days post-pLT) was associated with significantly higher one-year graft loss than late HAS (16%vs. 1%; p < 0.001). All deaths occurred in the early HAS group.

Conclusions

One-year graft and patient survival after HAS were high. Antithrombotic therapy alone and EVT were the most common management strategies. Early HAS was associated with lower one-year survival. Prospective studies with standardized diagnostic and treatment criteria are needed for validation.

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