ABSTRACT
Steno-Occlusive Disease of the transplant hepatic artery (HA) is not uncommon. It includes hepatic artery thrombosis (HAT) and hepatic artery stenosis (HAS). HAS has been speculated to progress to HAT (1-5) implicating, at least in part, that HAS andHAT are two contiguous components of the broader allograft ischemic spectrum. HAT (Fig. 1) is the most common hepatic arterial complication (1,2,6) occurring in 4-11% of adult transplants and 11-26% of pediatric transplants (1,6-10). HAS is the second most common of the arterial complications, occurring in 5-13% of transplants (1,2,11-14). As a result of the improving survival rate of hepatic transplant recipients, late vascular complications in hepatic allografts are likely to increase in prevalence (15). In addition, Doppler ultrasound (DUS) surveillance of the HA in orthotopic liver transplant (OLT) patients, which has become regularly used as of the mid-1990s, has revealed significantly more anatomic defects in the transplant HA (2,16). Prior to regular DUS surveillance, HAS and hepatic arterial kinks (HAK) represented 0-42% (weighted mean of 17%) of abnormal arterial angiograms in OLT recipients and now HAS and HAK represent 39-88% (weighted mean of 47%) of abnormal angiograms (1,7,16).
