Rescue for rare complications of the hepatic artery in living donor liver transplantation using grafts of autologous inferior mesenteric artery.
This report describes two rescued cases with rare complications of the hepatic artery in living-donor liver transplantation (LDLT). In both cases a segment of the autologous inferior mesenteric artery (IMA) was successfully used as an arterial graft for re-vascularization under microsurgery. The first case was that of a pseudoaneurysm of the hepatic artery, which caused massive gastrointestinal bleeding. The hepatic arteries of the pre- and post-aneurysm were divided, and the arterial graft from the recipient's IMA was interposed for reconstruction. The second case was that of an intimal dissection of the recipient's hepatic artery. Because the dissection extended to the root of the common hepatic artery, the autologous IMA was interposed between the donor's hepatic artery and the proximal stump of the recipient's splenic artery. Reconstruction using the arterial graft of the autologous IMA is feasible for re-vascularization of the hepatic artery in liver transplantation.
Asonuma
Katsuhiro
K
Department of Transplant and Pediatric Surgery, Kumamoto University, 1-1-1 Honjo Kumamoto City, 860-8556 Kumamoto, Japan. aso@k4.dion.ne.jp
Ohshiro
Hajime
H
Izaki
Toshiya
T
Okajima
Hideaki
H
Ueno
Mikako
M
Kodera
Atsushi
A
Inomata
Yukihiro
Y
D000328:Adult; D000784:Aortic Dissection / Q000209:etiology / Q000601:surgery*; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery* / Q000628:therapy; D000792:Angiography; D004621:Embolization, Therapeutic / Q000295:instrumentation; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006499:Hepatic Artery; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D017537:Mesenteric Artery, Inferior / Q000637:transplantation*; D008875:Middle Aged; D016879:Salvage Therapy