title: Artery reconstruction in liver transplantation: the best reconstruction of right hepatic artery variation.
abstract: BACKGROUND
  Variations on the anatomy of the hepatic artery are common, with incidence of 20-50%. In liver transplantation, back-table reconstruction is often necessary for an easier and prompt arterial anastomosis and so, the use of arterial patches has been related to lower the incidence of complications. However, when a right hepatic artery variation from the superior mesenteric artery is present, the reconstruction occasionally produces twisting and flow problems.
  
  
  METHODS
  Is described a surgical alternative for right hepatic artery variation reconstruction using a Carrel-patch from the superior mesenteric artery. The patch is anastomosed with the splenic artery stump to allow vertical orientation and improve blood flow.
  
  
  RESULTS
  Among 120 liver transplants, four consecutive cases of right hepatic artery variation were reconstructed using this technique. All of them showed good flow and patency in postoperative period.
  
  
  CONCLUSIONS
  The proposed technique proved to be an interesting alternative for the reconstruction of right hepatic artery variation in liver transplantation.
authors.affiliation: Liver Transplant Unit, Gastroenterology Department, Clinical Hospital of São Paulo University, School of Medicine, São Paulo, SP, Brazil. wellington@usp.br
authors.forename: Wellington
authors.initials: W
authors.lastname: Andraus
authors.forename: Luciana B P
authors.initials: LB
authors.lastname: Haddad
authors.forename: Liliana
authors.initials: L
authors.lastname: Ducatti
authors.forename: Rodrigo B
authors.initials: RB
authors.lastname: Martino
authors.forename: Vinicius Rocha
authors.initials: VR
authors.lastname: Santos
authors.forename: Luiz Augusto C
authors.initials: LA
authors.lastname: D'Albuquerque
mesh_terms: D006499:Hepatic Artery / Q000033:anatomy & histology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000379:methods*; D017410:Practice Guidelines as Topic; D014656:Vascular Surgical Procedures / Q000379:methods