Endovascular treatment of a recipient celiac trunk stenosis after orthotopic liver transplantation.

PURPOSE: To present the successful endovascular treatment of a severe recipient celiac trunk stenosis that led to allograft ischemia following liver transplantation.

CASE REPORT: A 56-year-old woman underwent orthotopic liver transplantation because of hepatitis C-induced cirrhosis. After the operation, routine hepatic Doppler ultrasonography showed a tardus parvus flow pattern in the hepatic artery, suggesting an impending hepatic artery thrombosis. Digital subtraction angiography (DSA), however, showed severe stenosis of the recipient celiac trunk and moderate splenic artery steal. The stenosis was dilated and stented in the same session. The postprocedural DSA showed good dilation of the lesion with immediate improvement of hepatic opacification. Follow-up Doppler ultrasound scans showed normal flow patterns in the hepatic artery at 3 and 6 months.

CONCLUSIONS

In the presence of a tardus parvus flow pattern on Doppler ultrasound after liver transplantation, the possibility of an undetected recipient celiac stenosis should be considered in the differential diagnosis. Such lesions can successfully be treated with angioplasty and stenting.