Liver graft vascular variant with 3 extra-hepatic arteries.
Vascular anatomy of the liver is varied, and the "standard" anatomy is seen in 55%-80% of cases. It is very important that extrahepatic arteries are identified precisely at the time of graft procurement to avoid injuries that might compromise the liver function. In the present case the liver donor had the vascular anatomy of Michels type VII, e.g. a hepatic artery originating from the celiac trunk and going to the left lobe, an accessory left hepatic artery coming from the left gastric artery, and a replaced right hepatic artery coming from the superior mesenteric artery. This pattern of vascular supply is uncommon, representing less than 5% of cases. The replaced hepatic artery was reconstructed in the back-table with polypropylene suture 7.0 by connecting it to the stump of the splenic artery, and the celiac trunk of the graft was anastomosed to the recipient common hepatic artery.
Department of Surgery, Division of Hepatobiliary Surgery and Transplantation, New York Medical College, New York, New York 10595, USA. Paulo_Martins@nymc.edu
Paulo N
PN
Martins
D002445:Celiac Artery / Q000601:surgery; D006499:Hepatic Artery / Q000002:abnormalities* / Q000601:surgery*; D006801:Humans; D008026:Ligation; D008099:Liver / Q000098:blood supply* / Q000601:surgery*; D016031:Liver Transplantation; D013157:Splenic Artery / Q000601:surgery; D013536:Suture Techniques; D014019:Tissue Donors; D014656:Vascular Surgical Procedures