title: Impact of aberrant arterial anatomy and location of anastomosis on technical outcomes after liver transplantation.
abstract: Variations in donor and recipient arterial anatomy frequently present challenges for surgeons when attempting to establish proper arterial inflow during liver transplantation. We reviewed our data on 233 adult primary liver transplants, conducted from January 1996 through December 2001, to determine the impact of these variations on the outcomes after liver transplantation. Twenty-four (10.3%) arterial complications were encountered at a mean of 2.27 months after transplant. Carrel patches for the anastomoses were not used in 33 patients (14%), which had no relation to arterial complications (P = 0.7). Sixty-one donors (26.2%) had at least one aberrant artery, which had no relation to arterial complications. However, use of donor celiac artery for anastomosis was significantly associated with higher arterial complications (16% versus other choices, P = 0.03). Furthermore, use of common hepatic recipient artery was associated with higher arterial complications (16%, P = 0.03). There were 58 total biliary complications (24.8%). Biliary complications were associated with the presence of arterial complications (P = 0.01). In conclusion, aberrant donor arterial anatomy was not associated with an increased rate of arterial complications; however, choice of location of arterial anastomosis may be a significant factor. Biliary complications were associated with arterial complications.
authors.affiliation: Henry Ford Transplant Institute, Henry Ford Hospital, Detroit, Michigan 48202, USA.
authors.forename: Marwan S
authors.initials: MS
authors.lastname: Abouljoud
authors.forename: Dean Y
authors.initials: DY
authors.lastname: Kim
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yoshida
authors.forename: Juan
authors.initials: J
authors.lastname: Arenas
authors.forename: John
authors.initials: J
authors.lastname: Jerius
authors.forename: Lauren
authors.initials: L
authors.lastname: Malinzak
authors.forename: Mohammad
authors.initials: M
authors.lastname: Raoufi
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Brown
authors.forename: Dilip K
authors.initials: DK
authors.lastname: Moonka
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006499:Hepatic Artery / Q000002:abnormalities* / Q000601:surgery; D006801:Humans; D008102:Liver Circulation / Q000502:physiology; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000601:surgery; D008113:Liver Neoplasms / Q000175:diagnosis / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D018570:Risk Assessment; D014019:Tissue Donors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*