title: A two-step strategy for enlargement of left arterial branch in a living related liver graft with dual arterial supply.
abstract: The use of small caliber arteries is probably responsible for the higher hepatic artery thrombosis rate initially reported after living related liver transplantation. We described a two-step strategy generating flow-induced enlargement of a small diameter artery in case of left graft dual arterial supply. The smaller arterial branch was ligated during a laparoscopic first-step procedure inducing a 30% enlargement of the remaining branch. The second-step donor hepatectomy was performed 1 week later using a larger artery for successful vascular anastomosis. The flow-induced enlargement of donor hepatic artery may help to reduce hepatic artery thrombosis risk after pediatric living related liver transplantation.
authors.affiliation: Hepatobiliary Surgery and Transplantation Unit, Beaujon University Hospital, 100, Bd Général Leclerc 92118 Clichy, France.
authors.forename: Richard
authors.initials: R
authors.lastname: Douard
authors.forename: Giuseppe Maria
authors.initials: GM
authors.lastname: Ettorre
authors.forename: Daniele
authors.initials: D
authors.lastname: Sommacale
authors.forename: Dominique
authors.initials: D
authors.lastname: Jan
authors.forename: Yann
authors.initials: Y
authors.lastname: Révillon
authors.forename: Olivier
authors.initials: O
authors.lastname: Farges
authors.forename: Jacques
authors.initials: J
authors.lastname: Belghiti
mesh_terms: D000328:Adult; D002675:Child, Preschool; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006498:Hepatectomy / Q000379:methods; D006499:Hepatic Artery / Q000033:anatomy & histology* / Q000601:surgery; D006801:Humans; D010535:Laparoscopy; D008099:Liver / Q000033:anatomy & histology / Q000098:blood supply; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D009679:Nuclear Family; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000379:methods