A novel technique for hepatic arterial reconstruction in living-donor liver transplant.
OBJECTIVE
Arterial reconstruction in patients undergoing living-donor liver transplant is technically difficult because of the small diameter of the vessels in the partial liver graft. In this study, we present our technique for hepatic arterial reconstruction.


METHODS
Since December 2005, we have performed 54 living-donor liver transplants, which are analyzed retrospectively in this report. In our technique now used at our institution, native and graft hepatic arteries are spatulated from both the anterior and posterior walls to provide a wide anastomosis. Computed tomographic angiography is used to evaluate the vascular anatomy and to measure the diameter of the graft hepatic arteries.


RESULTS
Mean follow-up was 7.2 +/- 5.5 months (range, 1-17 months). Nine of the 54 recipients died within 4 months of the surgery. At the time of this writing, the remaining 45 recipients (84%) are alive and demonstrating good graft function. In 2 recipients (3.7%) in this series, hepatic artery thromboses developed, which were treated with an interventional radiologic technique.


CONCLUSIONS
Our arterial reconstruction technique has enabled reconstruction of smaller arteries and arteries of various diameters without an operating microscope. The rate of complications in our patients is similar to that reported in similar individuals.
Haberal
Mehmet
M
Department of General Surgery and Transplantation, Baskent University Faculty of Medicine, Ankara, Turkey. rektorluk@baskent-ank.edu.tr
Sevmis
Sinasi
S
Karakayali
Hamdi
H
Moray
Gokhan
G
Yilmaz
Ugur
U
Ozcay
Figen
F
Torgay
Adnan
A
Aydogan
Cem
C
Arslan
Gulnaz
G
D000293:Adolescent; D000328:Adult; D015906:Angioplasty, Balloon, Coronary; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006499:Hepatic Artery / Q000601:surgery*; D006801:Humans; D007223:Infant; D016031:Liver Transplantation / Q000379:methods* / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016019:Survival Analysis; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000209:etiology / Q000628:therapy; D014656:Vascular Surgical Procedures / Q000009:adverse effects