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目的:探讨小儿肝移植术后急性肝动脉血栓和狭窄介入治疗的安全性和有效性，及其对患儿预后的影响。方法:2013年1月至2020年3月，在天津市第一中心医院放射科对8例肝移植术后急性肝动脉狭窄（hepatic artery stenosis, HAS）和肝动脉血栓形成（hepatic artery thrombosis，HAT）患儿进行了介入治疗。所有患儿中，男4例，女4例；中位年龄为9. 5个月，年龄范围为5~17个月。原发病为胆道闭锁6例，隐源性肝硬化1例，肝母细胞瘤合并室间隔缺损1例。对2例HAS患儿行球囊扩张治疗，6例HAT患儿行动脉内溶栓、球囊扩张、支架取栓及支架治疗。对患儿的临床资料、介入治疗、术后并发症和预后等情况进行收集、分析并总结。结果:8例肝移植患儿中，2例为HAS，6例为HAT，发生时间为肝移植术后2~14 d，中位时间为8. 5 d。所有患儿经介入治疗后均恢复血管通畅，术中未出现介入治疗相关并发症。对所有患儿随访至2020年3月，3例死亡，另5例中位随访时间为25个月，范围为6~86个月。对2例重度HAS患儿进行球囊扩张后，分别随访6个月和7个月，患儿肝动脉通畅，无介入相关并发症，无胆道并发症。6例HAT患儿经介入治疗后，1例再次闭塞，继续给予抗凝治疗，其余5例肝动脉通畅；该6例患儿中3例随访肝动脉通畅，但分别于术后36 d、40 d和11个月死亡，死亡原因2例为重症肺炎，1例为消化道出血；余3例出现肝移植术后缺血性胆道并发症经介入治疗后好转并拔管，截至2020年3月，3例患儿已存活时间分别为25、38和86个月。结论:介入治疗能够实现肝动脉的长期通畅性，虽然还会发生胆道并发症，但是仍可有效延长供肝存活时间，避免再次肝移植或延长再次肝移植时间。“,”Objective:To explore the safety and efficacy of interventional therapy for acute hepatic artery thrombosis (HAT) and hepatic artery stenosis (HAS) after liver transplantation (LT) and examine its prognostic impact in children.Methods:From January 2013 to March 2020, 8 children with HAT/HAS post-LT received interventional therapy. There were 4 boys and 4 girls with an average age of 9. 5 (5-17) months. The primary diseases were biliary atresia (n=6) , cryptogenic cirrhosis (n=1) and hepatoblastoma with ventricular septal defect (n=1). Two HAS children underwent balloon dilatation while 6 HAT children were subject to intravascular thrombolysis, balloon dilatation, stent embolectomy and stent. Clinical data, interventional therapy, postoperative complications and prognoses were analyzed.Results:HAS (n=2) and HAT (n=6) occurred at a median time of 8.5 (2-14) days. Vascular patency was restored after interventional therapy and no interventional therapy-related complications occurred intraoperatively. Follow-ups continued until March 2020. Except for 3 deaths, the remainders were followed up for an average period of 25 (6-86) months. Two children of severe hepatic artery stenosis were followed up for 6 and 7 months after balloon dilatation and hepatic artery remained patent without intervention-related or biliary complications. After interventional therapy for HAT (n=6) , anticoagulant therapy continued for 1 re-occluded case while the remainders maintained patent hepatic arteries; 3 deaths occurred at 36 days, 40 days and 11 months postoperatively due to gastrointestinal bleeding or severe pneumonia; the remaining 3 cases of ischemic biliary complications improved and became extubated. Up until March 2020, 3 children survived for 25, 38 and 86 months respectively.Conclusions:Interventional endovascular treatment of HAT/HAS after LT is both feasible and reliable for avoiding early retransplant or extending the time of retransplant. Some ischemic-type biliary lesions persist.