Continuous versus interrupted suture for hepatic artery anastomosis in liver transplantation: differences in the incidence of hepatic artery thrombosis.
BACKGROUND
Hepatic artery thrombosis (HAT) is a serious complication after orthotopic liver transplantation (OLT) and remains a significant cause of graft loss. HAT following OLT has been reported in 3% to 9% of patients. Among the surgical factors considered to be associated with HAT, arterial reconstruction might be the most important. The goal of this study was to compare the incidence of HAT between interrupted suture (IS) and continuous suture (CS) techniques during hepatic artery reconstruction in liver transplantation.


METHODS
We performed a retrospective analysis of 200 consecutive liver transplantations occurring between May 2002 and December 2006, including medical records for: age, gender, cold ischemic time, warm ischemic time, type and number of arterial anastomosis. Hepatic artery anastomoses were performed using a 7-0 prolene with a running CS in the first 105 patients (CS group), and with an IS in the last 95 patients (IS group).


RESULTS
Statistical analysis of age, gender, cold and warm ischemia time, and number of hepatic artery anastomoses was not different between the CS and IS groups. Eleven episodes of HAT were identified in the CS group (10%) and two episodes (2%) in the IS cohort, a significant difference (P = .0173).


CONCLUSIONS
Our results suggested that IS might be a better choice for hepatic artery anastomosis with a lower incidence of HAT.
Coelho
G R
GR
Department of Surgery, Centro de Transplante de Figado do Caera, Fortaleza, Ceara, Brazil.
Leitao
A S
AS
Cavalcante
F P
FP
Brasil
I R C
IR
Cesar-Borges
G
G
Costa
P E G
PE
Barros
M A P
MA
Lopes
P M
PM
Nascimento
E H
EH
da Costa
J I
JI
Viana
C F
CF
Rocha
T D S
TD
Vasconcelos
J B M
JB
Garcia
J H P
JH
D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006499:Hepatic Artery / Q000601:surgery*; D006526:Hepatitis C / Q000601:surgery; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013927:Thrombosis / Q000453:epidemiology*