title: Single artery reconstruction in left liver transplantation.
abstract: BACKGROUND
  A left liver graft in living donor liver transplantation often has 2 arterial stumps. The indication for multiple arterial reconstructions remains controversial. The aim of this retrospective study was to investigate whether single anastomosis of a left liver graft affects the outcome of living donor liver transplantation.
  
  
  METHODS
  When a hepatic graft had 2 arterial stumps, the thicker (dominant) stump was reconstructed first. After the initial reconstruction, another reconstruction was performed only if no pulsating flow was observed from the remnant stump. A total of 134 left liver grafts were divided into 3 groups: Group 1 (n = 70), 1 arterial stump on a graft with 1 arterial reconstruction; Group 2 (n = 59), 2 stumps with 1 arterial reconstruction; Group 3 (n = 5), 2 stumps with 2 arterial reconstructions. The incidence of hepatic arterial thrombosis, biliary stenosis, and patient survival was compared between Groups 1 and 2.
  
  
  RESULTS
  The incidence of arterial thrombosis and biliary stenosis, and the patient survival curves, were equivalent between Groups 1 and 2.
  
  
  CONCLUSIONS
  When the criteria were satisfied, single arterial reconstruction in a left liver graft with 2 arterial stumps did not affect the patient survival or biliary complications.
authors.affiliation: Artificial Organ and Transplantation Division, Department of Surgery and Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Sumihito
authors.initials: S
authors.lastname: Tamura
authors.forename: Junichi
authors.initials: J
authors.lastname: Kaneko
authors.forename: Takuya
authors.initials: T
authors.lastname: Iida
authors.forename: Makoto
authors.initials: M
authors.lastname: Mihara
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Makuuchi
authors.forename: Isao
authors.initials: I
authors.lastname: Koshima
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kokudo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003251:Constriction, Pathologic / Q000453:epidemiology; D005260:Female; D006085:Graft Survival / Q000502:physiology*; D006499:Hepatic Artery / Q000502:physiology / Q000601:surgery*; D006526:Hepatitis C / Q000601:surgery; D006801:Humans; D015994:Incidence; D008099:Liver / Q000098:blood supply* / Q000502:physiology / Q000601:surgery*; D008105:Liver Cirrhosis, Biliary / Q000601:surgery; D017114:Liver Failure, Acute / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013927:Thrombosis / Q000453:epidemiology; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*; D055815:Young Adult