Arterial reperfusion in human orthotopic liver transplantation by anastomosis of the celiac trunk to the right or left hepatic artery of the recipient.
Fifteen orthotopic liver transplants were performed from 23 April 1986 to June 1987 in 14 patients (age range 3-56 years). In 12 transplants, extracorporeal bypass was used. The installation was effected by suprahepatic and infrahepatic cava-caval and portaportal anastomoses. Arterial anastomosis was realized after reperfusing the graft through the vena porta. In 13 transplants the donor celiac trunk was anastomosed to the receptor's right hepatic artery. In one ten year-old girl, the donor celiac trunk was anastomosed to the left hepatic artery. In one patient who underwent retransplantation for rejection, the donor organ had two separate hepatic arteries and the right and left hepatic arteries were respectively anastomosed to the right and primitive hepatic arteries of the receptor. All patients were followed up periodically by Doppler echography and trimethyl-Br IDA 99 mTc scan, which, consistently confirmed the permeability of the anastomosis and dependent vessels, and the good perfusion and function of the grafts, which were free of infarcted areas. Three patients died at 30 and 31 days and postmortem studies demonstrated vascular permeability. Angiography was performed in one patient, evidencing a good vascular caliber in the hepatic arteriography.
Moreno González
E
E
Service of General, Digestive Surgery, 12 de octubre Hospital, University of Madrid, Spain.
García García
I
I
Gomez Sanz
R
R
González Pinto
I
I
Loinaz
C
C
Bercedo
J
J
Ibañez
J
J
Rico Selas
P
P
Urruzuno
P
P
Riaño
D
D
D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D000814:Aniline Compounds; D002199:Capillary Permeability / Q000502:physiology; D002445:Celiac Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000637:transplantation*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005998:Glycine; D006084:Graft Rejection; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007098:Imino Acids; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging; D016031:Liver Transplantation / Q000379:methods* / Q000401:mortality / Q000502:physiology; D008875:Middle Aged; D015609:Organotechnetium Compounds; D011172:Portography; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012039:Regional Blood Flow; D015424:Reperfusion / Q000379:methods*; D015996:Survival Rate; D014463:Ultrasonography
D000814:Aniline Compounds; D007098:Imino Acids; D015609:Organotechnetium Compounds; C034837:technetium Tc 99m mebrofenin; D005998:Glycine