{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T11:27:31Z","timestamp":1776338851254,"version":"3.51.2"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":335,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>Liver transplantation (LT) is the treatment of choice for patients with cirrhosis and hepatocellular carcinoma (HCC) not amenable to resection. Locoregional therapies for HCC are often used to reduce tumor burden, bridge patients to LT, and down-stage HCC so that patients are eligible for LT. We hypothesized that prior endovascular antitumor therapy may increase the risk of hepatic artery (HA) and biliary complications after LT. The aim of this study was to compare HA and biliary complications in LT recipients with HCC who received transarterial chemoembolization (TACE) before LT with complications in LT recipients with HCC who did not receive TACE before LT. This was a retrospective cohort study of HCC patients at two transplant centers. The prevalence of HA complications (HA thrombosis, stenosis, or pseudoaneurysm) and biliary complications (nonanastomotic stricture, bile leak, and diffuse injury) were compared between patients treated with or without TACE. There were 456 HCC patients with a median age of 61 years (77% were male, and 63% had hepatitis C virus), and 328 (72%) received TACE before LT. The overall prevalence of HA complications was 4.7% in the no-TACE group and 7.9% in the TACE group (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.22). All HA stenosis complications (n = 14) occurred in the TACE group (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.018 versus the no-TACE group). An older donor age and a lower albumin level significantly increased the odds of HA complications. There was a nonstatistically significant increased odds of HA complications in the TACE group versus the no-TACE group according to an adjusted analysis (odds ratio = 2.02, 95% confidence interval = 0.79-5.16, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.14). The overall prevalence of biliary complications was 16.4% in the no-TACE group and 19.8% in the TACE group (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.40). In conclusion, a lower pre-LT albumin level and an older donor age were significantly associated with higher odds of HA complications after LT. TACE was not associated with higher odds of overall HA complications but was associated with a higher prevalence of HA stenosis. Further studies are warranted to confirm the HA stenosis findings and elucidate the pathogenesis. <jats:italic toggle=\"yes\">Liver Transpl 20:1221-1228, 2014<\/jats:italic>. \u00a9 2014 AASLD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/lt.23945","type":"journal-article","created":{"date-parts":[[2014,7,5]],"date-time":"2014-07-05T16:19:01Z","timestamp":1404577141000},"page":"1221-1228","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":39,"title":["Hepatic Artery and Biliary Complications in Liver Transplant Recipients Undergoing Pretransplant Transarterial Chemoembolization"],"prefix":"10.1097","volume":"20","author":[{"given":"Aparna","family":"Goel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil","family":"Mehta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Guy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Fidelman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francis","family":"Yao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Roberts","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norah","family":"Terrault","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-10-20250124","doi-asserted-by":"crossref","first-page":"14851491","DOI":"10.1200\/JCO.2008.20.7753","article-title":"Hepatocellular carcinoma incidence, mortality, and survival trends in the United States from 1975 to 2005.","volume":"27","author":"Altekruse","year":"2009","journal-title":"J Clin Oncol"},{"key":"R2-10-20250124","doi-asserted-by":"crossref","first-page":"513521","DOI":"10.1053\/j.gastro.2009.09.067","article-title":"Aging of hepatitis C virus (HCV)infected persons in the United States: a multiple cohort model of HCV prevalence and disease progression.","volume":"138","author":"Davis","year":"2010","journal-title":"Gastroenterology"},{"key":"R3-10-20250124","doi-asserted-by":"crossref","first-page":"18201832","DOI":"10.1002\/hep.23594","article-title":"Nonalcoholic fatty liver disease and hepatocellular carcinoma: a weighty connection.","volume":"51","author":"Starley","year":"2010","journal-title":"Hepatology"},{"key":"R4-10-20250124","first-page":"12081236","article-title":"; for Practice Guidelines Committee of the American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma.","volume":"42","author":"Bruix","year":"2005","journal-title":"Hepatology"},{"key":"R5-10-20250124","doi-asserted-by":"crossref","first-page":"329338","DOI":"10.1055\/s-2007-1007122","article-title":"Prognosis of hepatocellular carcinoma: the BCLC staging classification.","volume":"19","author":"Llovet","year":"1999","journal-title":"Semin Liver Dis"},{"key":"R6-10-20250124","doi-asserted-by":"crossref","first-page":"953959","DOI":"10.1016\/S0168-8278(98)80123-2","article-title":"Arterial chemoembolization before liver transplantation in patients with hepatocellular carcinoma: marked tumor necrosis, but no survival benefit?","volume":"29","author":"Oldhafer","year":"1998","journal-title":"J Hepatol"},{"key":"R7-10-20250124","doi-asserted-by":"crossref","first-page":"873883","DOI":"10.1053\/jlts.2002.34923","article-title":"Liver transplantation for hepatocellular carcinoma: analysis of survival according to the intentiontotreat principle and dropout from the waiting list.","volume":"8","author":"Yao","year":"2002","journal-title":"Liver Transpl"},{"key":"R8-10-20250124","doi-asserted-by":"crossref","first-page":"31693177","DOI":"10.1245\/s10434-008-0071-3","article-title":"Bridging locoregional therapy for hepatocellular carcinoma prior to liver transplantation.","volume":"15","author":"Heckman","year":"2008","journal-title":"Ann Surg Oncol"},{"key":"R9-10-20250124","doi-asserted-by":"crossref","first-page":"618625","DOI":"10.1016\/j.jhep.2011.08.019","article-title":"Impact of geographic disparity on liver allocation for hepatocellular cancer in the United States.","volume":"56","author":"Kadry","year":"2012","journal-title":"J Hepatol"},{"key":"R10-10-20250124","doi-asserted-by":"crossref","first-page":"557563","DOI":"10.1053\/jlts.2003.50106","article-title":"Chemoembolization followed by liver transplantation for hepatocellular carcinoma impedes tumor progression while on the waiting list and leads to excellent outcome.","volume":"9","author":"Graziadei","year":"2003","journal-title":"Liver Transpl"},{"key":"R11-10-20250124","doi-asserted-by":"crossref","first-page":"819827","DOI":"10.1002\/hep.22412","article-title":"Excellent outcome following downstaging of hepatocellular carcinoma prior to liver transplantation: an intentiontotreat analysis.","volume":"48","author":"Yao","year":"2008","journal-title":"Hepatology"},{"key":"R12-10-20250124","doi-asserted-by":"crossref","first-page":"10201022","DOI":"10.1002\/hep.24199","article-title":"; for American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma: an update.","volume":"53","author":"Bruix","year":"2011","journal-title":"Hepatology"},{"key":"R13-10-20250124","doi-asserted-by":"crossref","first-page":"206212","DOI":"10.1007\/s11604-007-0216-5","article-title":"Angiographic evaluation of hepatic arterial damage after transarterial chemoembolization for hepatocellular carcinoma.","volume":"26","author":"Maeda","year":"2008","journal-title":"Radiat Med"},{"key":"R14-10-20250124","doi-asserted-by":"crossref","first-page":"164174","DOI":"10.1016\/j.critrevonc.2010.07.019","article-title":"Hepatic and biliary damage after transarterial chemoembolization for malignant hepatic tumors: incidence, diagnosis, treatment, outcome and mechanism.","volume":"79","author":"Sun","year":"2011","journal-title":"Crit Rev Oncol Hematol"},{"key":"R15-10-20250124","doi-asserted-by":"crossref","first-page":"119125","DOI":"10.1055\/s-2006-941442","article-title":"Complications of hepatic chemoembolization.","volume":"23","author":"Clark","year":"2006","journal-title":"Semin Intervent Radiol"},{"key":"R16-10-20250124","doi-asserted-by":"crossref","first-page":"775779","DOI":"10.1148\/radiology.214.3.r00mr31775","article-title":"Hepatic arterial complications in liver transplant recipients treated with pretransplantation chemoembolization for hepatocellular carcinoma.","volume":"214","author":"Richard","year":"2000","journal-title":"Radiology"},{"key":"R17-10-20250124","doi-asserted-by":"crossref","first-page":"307315","DOI":"10.1016\/j.jvir.2012.11.026","article-title":"Safety and efficacy of doxorubicin drugeluting bead transarterial chemoembolization in patients with advanced hepatocellular carcinoma.","volume":"24","author":"Prajapati","year":"2013","journal-title":"J Vasc Interv Radiol"},{"key":"R18-10-20250124","doi-asserted-by":"crossref","first-page":"793796","DOI":"10.1002\/hep.25869","article-title":"; for AASLD Practice Guidelines Committee. 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