title: Reconstructing single hepatic artery with two arterial stumps: biliary complications in pediatric living donor liver transplantation.
abstract: BACKGROUND
  Liver grafts can at times have two hepatic arterial stumps. This can result in a dilemma whether to reconstruct single or both the arteries. Hepatic artery (HA) thrombosis is the most dreaded complication in pediatric living donor liver transplantation (LDLT) as it can result in biliary complications and subsequent graft loss. We herein report the feasibility of reconstructing single hepatic artery in pediatric living donor liver transplantation having two arterial stumps in the liver graft.
  
  
  METHODS
  From 2008 to 2010, 87 pediatric patients undergoing LDLT were divided into three groups. Group 1 (n = 20): two HA stumps with two HA reconstruction, Group 2 (n = 22): two HA stumps with one HA reconstruction and Group 3 (n = 45): one HA stump with one HA reconstruction. The decision regarding the reconstruction of single or multiple HAs was made depending on the pre-operative radiological and intraoperative assessments.
  
  
  RESULTS
  The incidence of HA thrombosis (p = 0.126) and biliary complications (p = 0.617), was similar in the three groups.
  
  
  CONCLUSIONS
  Single HA reconstruction does not increase the risk of biliary strictures in pediatric LDLT recipients having dual hepatic arterial stumps in the liver graft.
authors.affiliation: Liver Transplantation Program and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Song, Kaohsiung, 833, Taiwan, karanrocs@hotmail.com.
authors.forename: Karan D
authors.initials: KD
authors.lastname: Julka
authors.forename: Tsan-Shiun
authors.initials: TS
authors.lastname: Lin
authors.forename: Chao-Long
authors.initials: CL
authors.lastname: Chen
authors.forename: Chih-Chi
authors.initials: CC
authors.lastname: Wang
authors.forename: Andrzej L
authors.initials: AL
authors.lastname: Komorowski
mesh_terms: D002675:Child, Preschool; D005240:Feasibility Studies; D005260:Female; D006499:Hepatic Artery / Q000601:surgery*; D006801:Humans; D007223:Infant; D008099:Liver / Q000098:blood supply / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D011183:Postoperative Complications / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*