title: Experiences of microsurgical reconstruction for variant hepatic artery in living donor liver transplantation.
abstract: There is an emergent need for improving the microsurgical technique of variant arterial anastomosis to reduce the often seen surgery-related complications. We describe in this article our experience in improving this technique, in 73 living donor liver grafts (64 right lobes, 9 left lobes) in patients with end-stage liver disease during living donor liver transplantation. The hepatic arteries were evaluated preoperatively with computed tomography and magnetic resonance angiography. In this series, 13 grafts (17.80 %) with variant hepatic artery were conducted arterioplasty on a back-table under a loupe or a high-power microscope, which included one recipient in situ interposition vessel graft of recipient proper hepatic artery for artery reconstruction. The back-table reconstruction time was 16 ± 5.6 min. No arterial thrombosis was found in these cases during the 6-month postoperative follow-up. On the basis of our experience, we suggest that back-table microsurgical plasty for graft with arterial variation should be applied to minimize operative difficulties and to avoid arterial complications in living donor liver transplantation.
authors.affiliation: Department of Hepatobiliary Surgery, Chinese PLA Postgraduate Medical School, Chinese PLA General Hospital, Beijing, China.
authors.forename: Yurong
authors.initials: Y
authors.lastname: Liang
authors.forename: Sheng
authors.initials: S
authors.lastname: Ye
authors.forename: Xianjie
authors.initials: X
authors.lastname: Shi
authors.forename: Wenbin
authors.initials: W
authors.lastname: Ji
authors.forename: Weidong
authors.initials: W
authors.lastname: Duan
authors.forename: Ying
authors.initials: Y
authors.lastname: Luo
authors.forename: Jiahong
authors.initials: J
authors.lastname: Dong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D002648:Child; D002675:Child, Preschool; D058625:End Stage Liver Disease / Q000601:surgery*; D005500:Follow-Up Studies; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007223:Infant; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008279:Magnetic Resonance Imaging; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*; D055815:Young Adult