Abstract Background Transarterial chemoembolization (TACE) in patients with hepatocellular cancer (HCC) on the waiting list for liver transplantation may be associated with an increased risk for hepatic artery complications. The present study aims to assess the risk for, primarily, intraoperative technical hepatic artery problems and, secondarily, postoperative hepatic artery complications encountered in patients who received TACE before liver transplantation. Methods Available data from HCC liver transplantation recipients across six European centres from January 2007 to December 2018 were analysed in a 1 : 1 propensity score-matched cohort (TACE versus no TACE). Incidences of intraoperative hepatic artery interventions and postoperative hepatic artery complications were compared. Results Data on postoperative hepatic artery complications were available in all 876 patients (425 patients with TACE and 451 patients without TACE). Fifty-eight (6.6 per cent) patients experienced postoperative hepatic artery complications. In total 253 patients who had undergone TACE could be matched to controls. In the matched cohort TACE was not associated with a composite of hepatic artery complications (OR 1.73, 95 per cent c.i. 0.82 to 3.63, P = 0.149). Data on intraoperative hepatic artery interventions were available in 825 patients (422 patients with TACE and 403 without TACE). Intraoperative hepatic artery interventions were necessary in 69 (8.4 per cent) patients. In the matched cohort TACE was not associated with an increased incidence of intraoperative hepatic artery interventions (OR 0.94, 95 per cent c.i. 0.49 to 1.83, P = 0.870) Conclusion In otherwise matched patients with HCC intended for liver transplantation, TACE treatment before transplantation was not associated with higher risk of technical vascular issues or hepatic artery complications.

中文翻译：

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肝移植前肝细胞癌的经动脉化疗栓塞和移植后血管并发症的风险：多中心观察队列和倾向评分匹配分析

摘要 背景肝移植等待名单上的肝细胞癌（HCC）患者的经动脉化疗栓塞（TACE）可能会增加肝动脉并发症的风险。本研究旨在评估肝移植前接受 TACE 的患者术中技术性肝动脉问题的风险，其次评估术后肝动脉并发症的风险。 方法在 1:1 倾向评分匹配队列（TACE 与无 TACE）中分析了 2007 年 1 月至 2018 年 12 月来自六个欧洲中心的 HCC 肝移植受者的可用数据。比较术中肝动脉介入治疗和术后肝动脉并发症的发生率。 结果所有 876 名患者（425 名接受 TACE 的患者和 451 名未接受 TACE 的患者）术后肝动脉并发症的数据均可用。58 名（6.6%）患者出现术后肝动脉并发症。总共 253 名接受 TACE 的患者可以与对照组相匹配。在匹配队列中，TACE 与复合肝动脉并发症无关（OR 1.73，95% CI 0.82 至 3.63，P = 0.149）。可获得 825 名患者的术中肝动脉干预数据（422 名接受 TACE 的患者和 403 名未接受 TACE 的患者）。69 名（8.4%）患者需要进行术中肝动脉干预。在匹配队列中，TACE 与术中肝动脉干预发生率增加无关（OR 0.94，95% CI 0.49 至 1.83，P = 0.870） 结论在其他匹配的打算进行肝移植的 HCC 患者中，移植前 TACE 治疗与技术性血管问题或肝动脉并发症的较高风险无关。