title: Use of the Right Lobe Graft With Double Hepatic Arteries in Living-Donor Liver Transplant.
abstract: We aimed to examine management of double hepatic artery reconstruction in patients under going living-donor liver transplant.
  
  
  
  Between January 2002 and June 2014, one thousand thirty-six living-donor liver transplants were performed at the Liver Transplant Institute of Malatya Inonu University. Living liver grafts with a single hepatic artery were used in 983 living-donor liver transplants, while grafts with double hepatic artery branches were used in 53 living-donor liver transplants. All of the liver grafts with double hepatic artery branches were right lobe grafts. Hepatic artery anastomosis technique and the other medical data of recipients who used grafts with double hepatic arteries were analyzed retrospectively.
  
  
  
  A double hepatic artery anastomosis was created in 43 recipients, while a single anastomosis was created in the remaining 10 because of ligation of the nondominant hepatic artery branch. In 40 recipients, double hepatic artery branches in the graft were anastomosed with the recipient's right and left hepatic artery. In the remaining 3 recipients, double hepatic artery branches in the graft were anastomosed with the recipient's right hepatic artery and large segment 4 hepatic arteries. Postoperative complications related with hepatic artery anas-tomoses developed in 3 recipients: hepatic artery thrombosis (n = 1), hepatic artery aneurysm (n = 1), and hepatic artery stenosis (n = 1). A recipient with hepatic artery aneurysm immediately underwent a retransplant. A recipient with a hepatic artery thrombosis relapsed and required retransplant, which was treated with thrombectomy on postoperative day 10. A recipient with hepatic artery stenosis was followed conservatively. In our series, the incidence of complications related with double hepatic artery anastomosis was found to be 6.9%.
  
  
  
  According to our experiences, a double hepatic artery anastomosis does not increase the risk of hepatic artery thrombosis and can be performed safely by surgeons who are experienced with hepatic vascular reconstructions in a living-donor liver transplant recipient.
authors.affiliation: From the Inonu University, Faculty of Medicine, Department of General Surgery, Malatya, Turkey.
authors.forename: Tugrul
authors.initials: T
authors.lastname: Cakir
authors.forename: M Zafer
authors.initials: MZ
authors.lastname: Sabuncuoglu
authors.forename: Vural
authors.initials: V
authors.lastname: Soyer
authors.forename: Baris
authors.initials: B
authors.lastname: Sarici
authors.forename: Suleyman
authors.initials: S
authors.lastname: Koc
authors.forename: Asım
authors.initials: A
authors.lastname: Onur
authors.forename: Bulent
authors.initials: B
authors.lastname: Unal
authors.forename: Sami
authors.initials: S
authors.lastname: Akbulut
authors.forename: Sezai
authors.initials: S
authors.lastname: Yilmaz
mesh_terms: D003251:Constriction, Pathologic; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods; D019520:Living Donors; D012189:Retrospective Studies; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology; D016896:Treatment Outcome; D014652:Vascular Diseases