title: Hepatic artery reconstruction and successful management of its complications in living donor liver transplantation using a right lobe.
abstract: BACKGROUND
  The aim of the present study was to improve the techniques of hepatic artery (HA) reconstruction and to properly manage arterial complications after living donor liver transplantation (LDLT).
  
  
  METHODS
  Prospectively collected data collected from 371 patients who underwent adult LDLT using a right lobe from January 2000 to August 2009 were retrospectively reviewed.
  
  
  RESULTS
  Of 17 patients (4.6%, 17/371) with double HA stumps in the graft, 12 patients (70.6%) received dual HA reconstruction. HA complications were composed of thrombosis (n = 6), pseudoaneurysm (n = 2), and stenosis (n = 4), showing 3.2% (12/371) of incidence. In patients with HA thrombosis, whereas operative thrombectomies with re-anastomosis rescued all the grafts in early attack (n = 3, ≤1 wk), angiographic thrombolysis successfully reestablished the flow in patients with late attack (n = 3, >1 wk). In all patients with HA complications, except for one, all of our treatment modalities - operation and angiographic intervention - resulted in successful rescue of grafts and no patient received re-transplantation because of HA complications.
  
  
  CONCLUSIONS
  Prompt diagnosis of HA complications by serial post-operative Doppler ultrasound and corresponding treatment strategies, including operative and radiological intervention, can rescue both grafts and patients without necessitating re-transplantation.
authors.affiliation: Department of Surgery, Daejeon St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: Say-June
authors.initials: SJ
authors.lastname: Kim
authors.forename: Young-Chul
authors.initials: YC
authors.lastname: Yoon
authors.forename: Jung-Hyun
authors.initials: JH
authors.lastname: Park
authors.forename: Deuk-Young
authors.initials: DY
authors.lastname: Oh
authors.forename: Young-Kyung
authors.initials: YK
authors.lastname: Yoo
authors.forename: Dong-Goo
authors.initials: DG
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017541:Aneurysm, False / Q000209:etiology / Q000517:prevention & control*; D003251:Constriction, Pathologic / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006499:Hepatic Artery / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D055815:Young Adult