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Objective: Orthotopic liver transplantation (OLT) has become the Major treatment for end-stage chronic liver disease.However, has a high risk of vascular complications because of complex reconstruction of the hepatic artery and portal vein, hepatic artery stenosis and thrombosis being the most common ones.Digital subtraction angiography (DSA) is considered the diagnostic criterion standard for post-orthotopic liver transplantation hepatic arterial complication, but have significant risks.MRA offers an alternative noninvasive technique for evaluating vascular complications.The objective of this study is to determine the diagnostic accuracy of MRA for hepatic arterial complication in OLT patients.Methods: A systematic literature search identified studies primarily examining the utility of MRA in detecting post-orthotopic liver transplantation hepatic artery complications.A meta-analysis was then performed according to the Quality of Reporting Meta-Analyses statement.The Meta-Disc software was used to analyse the reports and tests for sensitivity, specificity, and area under the summary receiver operating characteristic (sROC) curves.Heterogeneity in accuracy estimates was tested with the Spearman correlation coefficient and Chi-square.Results: Seven studies were included, a total of 251 OLT patients with clinical suspicion of hepatic arterial complication.The composite sensitivity and specificity were 0.92 (95% CI, 0.83-0.97) and 0.85 (95% CI, 0.79-0.970), respectively.The positive and negative likelihood ratios were 6.14 (95% CI, 3.54-10.67) and 0.15 (95% CI, 0.07-0.33), respectively.The area under the summary receiver-operating characteristic curve was 0.9409.All but 1 included study had significant design flaws that may have falsely increased the reported diagnostic accuracy.Conclusion: The high sensitivity and specificity demonstrated in this meta-analysis suggest that MRA is a promising test for diagnosing hepatic arterial complication in patients who have undergone liver transplantation.However, given the significant design flaws in most of the component studies, additional high-quality data are necessary before unequivocally recommending MRA in this setting.