[Anatomical variation of the donor hepatic arteries: analysis of 843 cases].
OBJECTIVE
To investigate the anatomical variations of donor hepatic artery and explore the measures that can be taken to avoid accidental hepatic artery injury during graft procurement and reconstruction.


METHODS
The data of totally 843 consecutive patients undergoing orthotopic liver transplantation (OLT) during the period from April 2001 to July 2006 was reviewed in relation to anatomical variation of the donor hepatic arteries. The variations of the hepatic artery, the relationship between the anomalous hepatic artery and accidental injury of the hepatic artery were analyzed.


RESULTS
In the 843 cases of OLT, the total anatomical variation rate of the donor hepatic arteries was 20.4% (172/843). The common variations included replaced or accessory right hepatic arteries originated from superior mesenteric artery (6.67%, 57/843), replaced or accessory left hepatic arteries originated from the left gastric artery (6.41%, 54/843) or from the celiac trunk and gastro-duodenal artery (1.66%, 14/843), replaced or accessory right hepatic arteries originated from the celiac trunk, common hepatic artery and gastro-duodenal artery (1.54%,13/843), replaced or accessory right hepatic arteries and left hepatic arteries coexistence (0.83%, 7/843), variation of the common hepatic artery from the superior mesenteric artery (1.54%, 13/843) or from the abdominal aorta (0.95%, 8/843).


CONCLUSIONS
During graft procurement and reconstruction, accidental injury of the hepatic artery is more likely in the presence of hepatic arterial variation, which can be a common clinical entity. Acquaintance with hepatic arterial variation and maintenance of the integrity of the superior mesenteric artery and celiac trunk are key to reducing potential hepatic artery injuries.
Yang
Yang
Y
Liver Transplantation Center, Third Affiliated Hospital of Sun Yat-sen University/Institute of Organ Transplantation, Sun Yat-sen University, Guangzhou 510630, China. yysysu@163.com
Jiang
Nan
N
Lu
Min-Qiang
MQ
Xu
Chi
C
Cai
Chang-Jie
CJ
Li
Hua
H
Yi
Shu-Hong
SH
Wang
Gen-Shu
GS
Zhang
Jian
J
Zhang
Jun-Feng
JF
Chen
Gui-Hua
GH
D001158:Arteries / Q000033:anatomy & histology / Q000473:pathology; D006801:Humans; D008099:Liver / Q000098:blood supply*; D016031:Liver Transplantation / Q000009:adverse effects; D012189:Retrospective Studies