title: Impact of very advanced donor age on hepatic artery thrombosis after liver transplantation.
abstract: BACKGROUND
  The impact of advanced donor age on hepatic artery thrombosis (HAT) after liver transplantation (LT) is controversial.
  
  
  METHODS
  We analyzed the incidence of and risk factors for HAT in LT with donors aged 70 years or older. Eighty patients were transplanted between 1998 and 2002 (group A) and 132 between 2003 and 2008 (group B).
  
  
  RESULTS
  In the more recent approach to hepatic artery (HA) reconstruction, the donor HA was systematically preferred to the Carrel patch/celiac trunk, the reconstruction of donor accessory right HA on the donor gastroduodenal artery significantly increased, and the use of interposition grafts was minimized. Group B showed higher Model for End-stage Liver Disease score, lower ischemia time, and lower use of the folding technique/mesenteric conduits. There were 10 cases of HAT (4.7%): 8 (10%) in group A and 2 (1.5%) in group B (P=0.007). Early HAT occurred in 7 (8.8%) patients in group A and in 2 (1.5%) in group B (P=0.02). Group A (P=0.01), anatomical variations of HA (P=0.005), and the use of interposition grafts (P=0.004) were all factors independently affecting HAT.
  
  
  CONCLUSIONS
  A low incidence of late HAT was observed in single-center LTs with very old donors. Early HAT decreased over time to largely acceptable rates because of more appropriate technical management.
authors.affiliation: General Surgery and Transplant Unit, Department of General Surgery and Organ Transplantation, University of Bologna, Bologna, Italy. matteo.cescon@aosp.bo.it
authors.forename: Matteo
authors.initials: M
authors.lastname: Cescon
authors.forename: Matteo
authors.initials: M
authors.lastname: Zanello
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Grazi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cucchetti
authors.forename: Matteo
authors.initials: M
authors.lastname: Ravaioli
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ercolani
authors.forename: Massimo
authors.initials: M
authors.lastname: Del Gaudio
authors.forename: Augusto
authors.initials: A
authors.lastname: Lauro
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Morelli
authors.forename: Antonio Daniele
authors.initials: AD
authors.lastname: Pinna
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D046148:Donor Selection; D005260:Female; D006499:Hepatic Artery / Q000601:surgery; D006801:Humans; D007558:Italy; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology*; D014019:Tissue Donors; D055815:Young Adult