Annals of Transplantation最新文献

{"title":"Risk Factors for Multidrug-Resistant Bacterial Infections After Liver Transplantation.","authors":"Qiusi Hao, Hong Wang, Qikun Zhang, Fengjuan Guo, Xinxing Liu, Lili Zhang","doi":"10.12659/AOT.949047","DOIUrl":"https://doi.org/10.12659/AOT.949047","url":null,"abstract":"<p><p>BACKGROUND Multidrug-resistant bacterial (MDRB) infections are a major complication after liver transplantation, contributing to increased morbidity, prolonged hospitalization, and reduced survival. Immunosuppression, invasive procedures, and prolonged intensive care stay are known to increase susceptibility to MDRB. However, specific clinical risk factors in post-transplant patients remain incompletely understood. This study aimed to identify risk factors for MDRB infections following liver transplantation. MATERIAL AND METHODS We retrospectively analyzed data on 350 patients who underwent liver transplantation at our hospital between January 2019 and March 2023. Patients were divided into a non-MDRB infection group (300 cases) and an MDRB infection group (50 cases). Clinical parameters were compared between groups. Multivariate logistic regression was used to identify independent risk factors for MDRB infection. RESULTS The 1-year survival rate was significantly lower in the MDRB group compared to the non-MDRB group (72.0% vs 87.7%, P<0.001). Univariate analysis identified 6 potential risk factors: tracheal intubation ≥48 h post-transplant, reoperation, tacrolimus (Tac) blood concentration, hospital stay ≥30 days, Child-Pugh classification, and intensive care unit stay ≥72 h (all P<0.05). Multivariate analysis showed that tracheal intubation ≥48 h (OR=2.714, 95% CI: 1.821-4.260, P=0.015), reoperation (OR=2.681, 95% CI: 2.015-5.402, P=0.001), and peak Tac blood concentration (OR=2.612, 95% CI: 1.405-4.710, P=0.007) were independent risk factors. CONCLUSIONS Prolonged tracheal intubation, reoperation, and elevated Tac blood concentration are key risk factors for MDRB infections after liver transplantation. Early identification and management of these factors may reduce MDRB incidence and improve patient outcomes.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e949047"},"PeriodicalIF":1.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Transplant Outcomes in Patients with Previously Treated Extrahepatic Malignancies Undergoing Living Donor Liver Transplantation.","authors":"Amy Kim, Shin Hwang, Chul-Soo Ahn, Deok-Bog Moon, Tae-Yong Ha, Gi-Won Song, Dong-Hwan Jung, Gil-Chun Park, Woo-Hyoung Kang, Young-In Yoon, Sung-Gyu Lee","doi":"10.12659/AOT.949461","DOIUrl":"10.12659/AOT.949461","url":null,"abstract":"<p><p>BACKGROUND Post-transplant outcomes were analyzed in adult patients with primary extrahepatic malignancies (EHM) who underwent living donor liver transplantation (LDLT). Few studies to date have analyzed post-transplant outcomes in adult patients with primary extrahepatic malignancies (EHM) who underwent LDLT. MATERIAL AND METHODS The study cohort included 109 patients who were treated for EHM more than 6 months before LDLT between January 2000 and December 2022. The clinicopathological characteristics of EHMs and outcomes of LDLT, including EHM recurrence and patient survival, were analyzed. RESULTS The most common primary EHM was stomach cancer (27.5%), followed by thyroid (11.0%), breast (11.0%), colorectal (10.1%), and kidney (10.1%) cancer. The mean and median intervals between final EHM treatment and LT were 84.9±78.0 months and 27 months (range: 6-336 months), respectively. During mean follow-up period of 84.9±78.0 months, 15 patients died. The 1-, 5-, 10-, and 20-year patient survival rates were 96.3%, 88.5%, 85.0%, and 70.8%, respectively. Five patients (4.6%) experienced post-transplant EHM recurrence, with 4 dying due to sepsis during EHM treatment (n=2), progression of EHM recurrence (n=1), and pneumonia (n=1). The mean and median intervals between LT and recurrence of pretransplant EHM were 71.6±82.8 months and 25 months (range: 19-213 months), respectively. The cumulative 1-, 5-, 10-, and 20-year EHM recurrence rates were 0%, 3.1%, 4.6%, and 18.3%, respectively. CONCLUSIONS Patients with previously treated EHMs may be considered for LDLT following careful multidisciplinary evaluation and implementation of individualized post-transplant surveillance strategies.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e949461"},"PeriodicalIF":1.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Kidney Transplant Type on Coronary Endothelial Function in Individuals with Chronic Kidney Disease.","authors":"Göksel Guz, Rasim Onur Karaoğlu, Sezen Kumaş Solak, Ebru Burcu Demirgan, Serdar Demirgan","doi":"10.12659/AOT.949664","DOIUrl":"10.12659/AOT.949664","url":null,"abstract":"<p><p>BACKGROUND Patients with chronic kidney disease (CKD) have a markedly increased cardiovascular risk, largely due to persistent endothelial dysfunction (ED). Kidney transplantation improves cardiovascular status, but whether transplant type-living donor (LDT) or cadaver donor transplantation (CDT)-differentially affects coronary endothelial function remains unclear. MATERIAL AND METHODS In this prospective observational study, 75 kidney transplant recipients (LDT: n=50; CDT: n=25) and 25 healthy controls (HC) underwent CFVR measurement at baseline (CFVR-1) and 6 months post-transplantation (CFVR-2). Left ventricular ejection fraction (LV-EF), diameters, and NT-proBNP were also assessed. Group comparisons and pre-/post-transplant changes were analyzed. RESULTS Baseline CFVR was higher in HC than in transplant groups (p0.05), but CFVR-1 0.05). A ≥10% EF increase occurred in 36% of patients in each group. CONCLUSIONS Kidney transplantation improves coronary endothelial function and cardiac performance regardless of donor type, though severe baseline CFVR impairment is more common in cadaveric recipients.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e949664"},"PeriodicalIF":1.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145123920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Recipient Variables on Transplant Survival Following Marginal Kidney Donation: Analysis of a Mate Kidney Cohort.","authors":"Ariadni Androvitsanea, Katharina M Heller, Hendrik Apel, Frank Kunath, Peter J Goebell, Bernd Wullich, Ulrich Rother, Christoph Daniel, Kerstin Amann, Carsten Willam, Mario Schiffer","doi":"10.12659/AOT.948739","DOIUrl":"10.12659/AOT.948739","url":null,"abstract":"<p><p>BACKGROUND Transplantation using kidneys from older donors or those with specific risk factors (marginal kidneys) offers improved outcomes compared to remaining on dialysis. Matched-pair analysis potentiates control for confounding donor factors and the impact of recipient characteristics on transplant survival. MATERIAL AND METHODS Data from 200 transplants using marginal deceased donors were retrospectively analyzed. Paired comparisons between mate kidney recipients, McNemar's test, and multivariable Cox regression were performed to identify recipient factors and histological features from zero-time biopsy associated with graft survival. RESULTS Graft survival was significantly longer in recipients with shorter pre-transplant dialysis exposure (mean 58.10 vs 68.86 months, P=0.001) and fewer HLA mismatches (3.40 vs 3.78, P=0.013). Severe acute tubular injury (ATI) in pre-implantation biopsy was associated with reduced graft survival (P=0.04). In multivariable Cox regression, the presence of severe ATI (P<0.001), older recipient age (HR=0.1 per year, P=0.002), HLA mismatches (HR=1.21, P=0.011), and elevated 1-year serum creatinine level (HR=0.72, P=0.030) remained independently associated with shorter graft survival. CONCLUSIONS Matched-pair analysis and multivariable modelling identified recipient dialysis duration, age, HLA mismatches,1-year serum creatinine, and pre-transplant biopsy findings, particularly severe ATI, as key predictors of graft survival in marginal kidney transplantation. These insights may support improved recipient selection and post-transplant management of marginal-donor kidneys.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e948739"},"PeriodicalIF":1.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Analgesic Effects of Anterior Quadratus Lumborum Block vs Intravenous Analgesics Administered to Donors and Recipients in Renal Transplantation Surgery: A Prospective Cohort Study.","authors":"Fatma Acil, Andaç Dedeoğlu, Ali İhsan Yürekli, Hülya Tosun Söner, Osman Uzundere, Ramazan Danış, Nurettin Ay, Cem Kıvılcım Kaçar, Erhan Gökçek, Sedat Kaya","doi":"10.12659/AOT.949037","DOIUrl":"10.12659/AOT.949037","url":null,"abstract":"<p><p>BACKGROUND Among the limited analgesic options, plane blocks are of great importance in providing effective postoperative analgesia to donors and recipients in renal transplantation surgery. We aimed to demonstrate that anterior type quadratus lumborum plane block provides better analgesia than intravenous paracetamol in open and closed nephrectomy patients. MATERIAL AND METHODS We conducted a prospective cohort study. Renal recipients and donors were divided into 2 groups. One group received anterior quadratus lumborum plane block and the other group received intravenous paracetamol. Pain levels and total tramadol consumption at 1, 2, 6, 12, and 24 hours postoperatively were recorded as primary data. RESULTS Demographic data of donors and recipients were similar between the QLB and IVA groups, and there was no significant difference in the time spent for surgery, anesthesia, or hospitalization. In renal donors, we found that total tramadol consumption and pain scores of the quadratus lumborum block group were significantly lower than in the intravenous analgesia group (P<0.001). In renal recipients, we found that postoperative tramadol consumption and pain levels of the quadratus lumborum block group were significantly lower than in the intravenous analgesia group (P<0.001). Additionally, the duration of rescue analgesic requirement was significantly shorter in renal recipients and donors who underwent quadratus lumborum plane block compared to the intravenous analgesic group (P<0.001). CONCLUSIONS The anterior type quadratus lumborum plane block provides effective analgesia to recipients and donors in renal transplantation surgery and reduces postoperative opioid consumption.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e949037"},"PeriodicalIF":1.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New-Onset Diabetes After Liver Transplantation: An SRTR Database Study of Incidence and Risk Factors.","authors":"Saxiao Tang, Shengmin Mei, Shichao Shen, Li Wang, Yue Wu, Jie Xiang, Zhiwei Li","doi":"10.12659/AOT.949062","DOIUrl":"10.12659/AOT.949062","url":null,"abstract":"<p><p>BACKGROUND New-onset diabetes after transplantation (NODAT) is a common complication following liver transplantation, with serious patient and graft outcomes. The recent advances in transplant techniques and management have improved patient survival and consequently led to an increase in NODAT. Therefore, this study aimed to evaluate the current trends in the incidence, risk factors, and impact of NODAT on outcomes using a large national-level database. MATERIAL AND METHODS Adult liver transplant recipients who underwent the procedure between 2013 and 2022 were identified from the Scientific Registry of Transplant Recipients database. NODAT was defined as diabetes newly diagnosed after transplantation. Logistic regression was used to identify risk factors. Kaplan-Meier analysis and Cox regression analysis were performed to assess the impact of NODAT on patient and graft survival. RESULTS Among 39 828 recipients who met the study criteria, 2973 (7.5%) developed NODAT. Independent risk factors for NODAT included recipient age >50 years, male sex, BMI >25 kg/m², cytomegalovirus infection, steroid and tacrolimus use at discharge, deceased donor, longer warm ischemia time, and donor diabetes history. NODAT was associated with decreased graft survival (HR=1.28, 95% CI=1.10-1.48, P<0.001) but not patient survival. Moreover, the recipients who developed NODAT had higher rates of graft failure due to vascular thrombosis. CONCLUSIONS NODAT affects 7.5% of liver transplant recipients and is associated with decreased graft survival. Identifying high-risk patients and optimizing modifiable risk factors may help improve outcomes.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e949062"},"PeriodicalIF":1.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of HLA Alleles with IgA Nephropathy and Its Recurrence After Kidney Transplantation.","authors":"Karol Graňák, Matej Vnučák, Patrícia Kleinová, Tímea Blichová, Andrej Kollár, Andrej Čereš, Ivana Dedinská","doi":"10.12659/AOT.949689","DOIUrl":"https://doi.org/10.12659/AOT.949689","url":null,"abstract":"<p><p>BACKGROUND The recurrence of IgA nephropathy (IgAN) after kidney transplantation (KT) varies between 9% and 51%. Our analysis aimed to identify risk and protective HLA alleles for the development of IgAN and its recurrence after KT. MATERIAL AND METHODS This retrospective single-center analysis included all patients after KT. Patients underwent HLA typing prior to being listed on the waiting list for KT. Comparisons were performed with a cohort of 10 000 healthy donors from the Eurotransplant registry. RESULTS A total of 470 patients were included. Biopsy-proven IgAN, as the underlying cause of renal failure, was found in 7.2% (n=48), of whom 77% were male (n=37). The DRB1*11 allele was present in 47.92% and was identified as a significant risk factor for IgAN (OR 2.09, P=0.0048). The DRB1*03 allele was detected in 4.17%, and we identified it as potentially protective (OR 0.2, P=0.5472). Recurrence of IgAN was detected in 20.8%, 100% of whom were male. The mean time to confirm recurrence was 56.1 months. We identified the DRB1*11 risk allele in 77.8% of patients with confirmed recurrence but did not identify it as an independent risk factor (HR 2.3967; P=0.3956). We found a significant correlation of IgAN recurrence with the development of DSA after KT (r 0.3980, P=0.0218). CONCLUSIONS Our study identified a 20.8% incidence of IgAN recurrence after KT; 77.8% of these patients had the HLA-DRB1*11 allele, which we also identified as a risk allele for the development of IgAN in native kidneys. De novo DSA after KT was correlated with IgAN recurrence.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e949689"},"PeriodicalIF":1.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Intervention of Portal Vein Stenosis in Pediatric Patients After Liver Transplantation: A Single-Center Experience.","authors":"Mingqi Shuai, Weili Wang, Yigang Qian, Zhiwei Li, Shunliang Gao, Jian Wu, Jun Yu, Min Zhang, Yan Shen, Xueli Bai, Tingbo Liang, Wei Zhang","doi":"10.12659/AOT.949532","DOIUrl":"10.12659/AOT.949532","url":null,"abstract":"<p><p>BACKGROUND Portal vein stenosis (PVS) is a prevalent complication following pediatric liver transplantation (pLT) and significantly impacts long-term graft outcomes. This study assessed the efficacy and safety of balloon angioplasty and stent placement, calculated rates of restenosis or reintervention, and determined optimal interventional strategies for managing PVS following pLT. MATERIAL AND METHODS We retrospectively analyzed 884 pLT recipients at our institution. PVS occurred in 67 patients; 64 successfully underwent interventional procedures. We comparatively analyzed patients who achieved satisfactory results following initial balloon angioplasty with those who required subsequent interventions. Factors, including history of portal vein bridging and donor-recipient portal vein discrepancy rate, were analyzed. Significant factors were used to develop a logistic regression-based risk prediction model. Kaplan-Meier curves estimated patient and graft survival rates. RESULTS Fifty-two patients (81.25%) demonstrated satisfactory recovery following initial balloon angioplasty among the 64 pLT recipients with PVS. Twelve patients had restenosis; 10 underwent subsequent interventions with successful outcomes. A comparative analysis between the initial balloon angioplasty success group and the reintervention group showed significant differences between the groups with respect to portal vein bridging history and portal vein discrepancy rate (P<0.05). A logistic regression-based prediction model for restenosis was established. Kaplan-Meier survival analysis indicated an overall patient survival rate of 98.5% and a graft survival rate of 92.5% during the study period. CONCLUSIONS Patients with portal vein bridging history or poor donor-recipient PV matching are more prone to restenosis after initial balloon angioplasty. For such cases, we recommend direct stent placement as the initial treatment strategy.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e949532"},"PeriodicalIF":1.4,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Atropine Protocol Enhances Dobutamine Stress Echocardiography in End-Stage Liver Disease: A Practical Cardiac Risk Stratification Tool Before Liver Transplantation.","authors":"Özge Çetinarslan, Sinan Efe Yazıcı, Ahmet Atasever","doi":"10.12659/AOT.950166","DOIUrl":"10.12659/AOT.950166","url":null,"abstract":"<p><p>BACKGROUND Chronotropic incompetence often prolongs dobutamine stress echocardiography (DSE) and provokes adverse events in liver-transplant (LT) candidates. We evaluated whether administering atropine 1 stage earlier than conventionally recommended improves test efficiency and tolerability. MATERIAL AND METHODS In this retrospective single-center study, 69 end-stage liver disease patients were assigned to 3 cohorts according to the protocol used: Group 1 - high-dose dobutamine alone (n=24); Group 2 - \"late\" atropine (1 mg at 40 µg/kg/min; n=22); Group 3 - \"early\" atropine (at 30 µg/kg/min; n=23). Primary endpoints were target heart rate (HR) achievement, procedure time, hypotension, and ventricular extrasystole (VES). RESULTS Target HR was reached in 83%, 86%, and 95% of Groups 1-3, respectively (P<0.001). Mean procedure duration fell from 27.82±2.06 min with late atropine to 18.48±0.95 min with early atropine (-33.6%). Hypotension dropped from 50.0% to 8.7% (relative reduction≈83%) and VES decreased from 59.1% to 13.0% (≈78%). Cumulative dobutamine exposure was halved (≈1 113→≈554 µg/kg). No early-atropine patients experienced test-terminating complications. CONCLUSIONS Introducing atropine at the preceding dobutamine stage offers a simple, cost-neutral modification that accelerates DSE, halves drug exposure, and substantially improves hemodynamic and arrhythmic safety in LT candidates. Prospective trials should confirm whether this streamlined protocol can be adopted as the new standard for chronotropically challenging patients.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e950166"},"PeriodicalIF":1.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-Arterial Contrast-Enhanced Ultrasound for Transcatheter Thrombolysis in Post-Transplant Hepatic Artery Thrombosis: A Preliminary Study.","authors":"Liqi Sun, Yijun Li, Kai Feng, Dong Zhao, Hong Yu, Zhiyan Li, Ningbo Zhao","doi":"10.12659/AOT.947500","DOIUrl":"10.12659/AOT.947500","url":null,"abstract":"<p><p>BACKGROUND Hepatic artery thrombosis is the most common and severe vascular complication after liver transplantations. Transcatheter arterial thrombolysis is a viable alternative with high selectivity, low drug dosage, high local drug concentration, and minimal effect on systemic coagulation function. Intra-arterial contrast-enhanced ultrasound (IA-CEUS) is radiation-free and repeatable, can be performed bedside, and could be an alternative for continuous monitoring. We described the efficacy of IA-CEUS in assessing the effect of continuous transcatheter arterial thrombolysis in post-liver transplant hepatic artery thrombosis in a series of cases. MATERIAL AND METHODS Eight patients with diagnosis of hepatic artery thrombosis after liver transplantation between November 2016 and May 2023 were selected. All 8 patients underwent continuous transcatheter arterial thrombolysis, using urokinase. Dynamic IA-CEUS monitoring was performed for each patient during the thrombolysis treatment. Hepatic artery digital subtraction angiography was used to verify the results. RESULTS Two patients showed a hepatic artery perfusion defect. Six patients demonstrated good perfusion of artery. Three patients developed biloma. One patient developed a dissection aneurysm. One patient developed a pseudoaneurysm with catheter displacement in it. One patient developed retroperitoneal hematoma. None of the patients experienced contrast agent-related complications. CONCLUSIONS IA-CEUS was found to be safe and feasible as a new option for evaluating the efficacy of transcatheter arterial thrombolysis in post-liver transplant hepatic artery thrombosis.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e947500"},"PeriodicalIF":1.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}