Does variant hepatic artery anatomy in a liver transplant recipient increase the risk of hepatic artery complications after transplantation?
OBJECTIVE
Our aim was to determine whether variant hepatic artery anatomy in a liver transplant recipient increases the risk of hepatic artery complications after liver transplantation.


METHODS
The study group consisted of 84 patients who underwent gadolinium-enhanced 3D MR angiography before orthotopic liver transplantation in which a branch patch arterial anastomosis at the gastroduodenal takeoff was used. MR angiography studies were retrospectively reviewed and assessed for the presence and type of variant hepatic artery anatomy. The diameter of the distal common hepatic artery was measured. The incidence of posttransplantation hepatic artery stenosis or thrombosis was assessed.


RESULTS
Seven (8.3%) of the 84 patients developed hepatic artery complications after transplantation. Of the 24 patients with variant hepatic artery anatomy, five (20.8%) had posttransplantation/ hepatic artery complications. In contrast, only two (3.3%) of the 60 patients with classic hepatic artery anatomy had complications. The higher complication rate in patients with variant hepatic artery anatomy was statistically significant (p < 0.05). The odds ratio was 7.6 (95% confidence interval, 1.4-42.6). The diameter of the distal common hepatic artery was smaller in patients with variant hepatic artery anatomy compared with those with classic hepatic artery anatomy (range, 4.3-7.1 mm [mean, 5.8 mm] vs 4.0-8.9 mm [mean 6.3 mm], p < 0.05), and it was also smaller in patients who had posttransplantation hepatic artery complications compared with those who had no complications (range, 4.2-6.3 mm [mean, 5.2 mm] vs 4.0-8.9 mm, [mean, 6.2 mm], p < 0.01).


CONCLUSIONS
Variant hepatic artery anatomy in a liver transplant recipient increased the risk of hepatic artery complications after transplantation. The smaller caliber of the native common hepatic artery may contribute to the higher risk.
Ishigami
Kousei
K
Department of Radiology, University of Iowa, Carver College of Medicine, 200 Hawkins Dr., 3885 JPP, Iowa City, IA 52242-1077, USA. kousei-ishigami@uiowa.edu
Zhang
Yan
Y
Rayhill
Stephen
S
Katz
Daniel
D
Stolpen
Alan
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006499:Hepatic Artery / Q000002:abnormalities*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D015994:Incidence; D016031:Liver Transplantation; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012307:Risk Factors
D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA