An early and proactive interventional radiology approach may represent a feasible option for managing early hepatic artery thrombosis after pediatric liver transplantation, achieving primary technical success in 84.6% of patients and long-term hepatic artery patency in 61.5%.
Early hepatic artery thrombosis (HAT) occurred in 3.8% of pediatric liver transplant patients in this cohort.
Interventional radiology procedures achieved primary technical success in 84.6% of pediatric HAT patients.
Hepatic artery patency at three months was achieved in 76.9% of patients who underwent interventional radiology.
Only two of the thirteen patients who underwent interventional radiology management ultimately required retransplantation.
Prompt timing of interventional radiology after diagnosis was identified as a key factor in the approach's feasibility.
This research studied what happens when children who receive liver transplants develop a serious complication called hepatic artery thrombosis (HAT), where the main blood vessel supplying the transplanted liver becomes blocked. Traditionally, this has required emergency surgery. The study examined outcomes when doctors instead used a minimally invasive technique called interventional radiology — threading a thin tube through blood vessels to open the blockage using balloon dilation and clot-dissolving or vessel-relaxing drugs, sometimes with a small tube called a stent to keep the vessel open. Out of 340 pediatric liver transplants performed over 21 years, 13 children (about 1 in 26) developed early HAT and were treated this way. The results showed that the procedure successfully restored blood flow in about 85% of cases immediately after the procedure, and about 77% of patients still had an open hepatic artery three months later. In the longer term, 61.5% maintained a functioning hepatic artery. Importantly, only 2 of the 13 children ultimately needed a second liver transplant. The procedures were performed very quickly — typically within one day of the transplant — which the authors suggest is important to the approach's success. This research suggests that early, proactive use of interventional radiology techniques could be a viable alternative to surgery for managing this dangerous complication in children after liver transplantation. Because the study was small (13 patients) and conducted at a single center over many years, larger studies would be needed to confirm these findings. Nonetheless, the results indicate this approach may help save transplanted livers and reduce the number of children who need to undergo a second transplant.
Maria M, Mercedes P, Andrés M, Daniel B, Mireia C, Mar D, et al.. (2026). Interventional Radiology Management After Early Hepatic Artery Thrombosis Following Pediatric Liver Transplantation.. Pediatric transplantation. https://doi.org/10.1111/petr.70423