[Reconstruction of hepatic artery in adult to adult living donor liver transplantation in 104 patients].
OBJECTIVE
To report the experience of hepatic artery reconstruction with adult-to-adult living donor liver transplantation (ALDLT) using right lobe liver grafts.


METHODS
From January 2002 to August 2007, 104 patients underwent ALDLT using right lobe grafts. Hepatic arteries of donors and recipients were assessed carefully with spiral CT angiography and DSA before ALDLT. All patients underwent reconstruction of hepatic artery between right lobe liver grafts of donor and recipient which included the anastomosis between right hepatic artery of donors and recipients; the reconstruction of right hepatic artery between donor grafts and left hepatic artery of recipients; interpositional bypass using autogenous saphenous vein and cryopreserved iliac artery between right hepatic artery of donors and hepatic artery, common hepatic artery and abdominal aorta of recipients. The microsurgical technique was employed under the magnification of 3.5 times and operative microscope of 5-10 times.


RESULTS
In these series, HAT occurred in 2 recipients at Days 1 and 7 post-ALDLT (1.9%). Both were revascularized with autogenous saphenous vein between right hepatic artery of donor and abdominal aorta of recipient. HAT occurred in 1 recipient at Days 90 post-ALDLT, but no symptom was presented. There was no severe complication and mortality related to hepatic artery reconstruction in recipients. No HAT, hepatic artery stenosis and aneurysm occurred during the follow-up period of 2-60 months. The 1, 2 and 3-year survival rates were 89.3%, 76.0% and 69.3% respectively.


CONCLUSIONS
Careful evaluation of hepatic artery condition and using microsurgical techniques are important for safer arterial reconstruction and a long-term patency of hepatic artery in living donor liver transplantation in adults using right lobe liver grafts.
Zhao
Ji-Chun
JC
Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China. zhaojc3@126.com
Yan
Lu-Nan
LN
Li
Bo
B
Ma
Yu-Kui
YK
Zeng
Yong
Y
Wen
Tian-Fu
TF
Wang
Wen-Tao
WT
Yang
Jia-Yin
JY
Xu
Ming-Qing
MQ
Chen
Zhe-Yu
ZY
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006085:Graft Survival; D006499:Hepatic Artery / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D055815:Young Adult