Outcome of partial reconstruction of multiple hepatic arteries in pediatric living donor liver transplantation using left liver grafts.
Partial liver grafts used in living donor liver transplantation (LDLT) may have multiple hepatic artery (HA) stumps. This study was designed to validate the safety of partial reconstruction of multiple HAs in pediatric LDLT cases. From January 2000 to June 2014, 136 pediatric LDLT recipients were categorized into three groups: single HA group (Group 1, n = 74), multiple HAs with total reconstruction group (Group 2, n = 23), and multiple HAs with partial reconstruction group (Group 3, n = 39). Partial reconstruction was performed only when there was pulsatile back-bleeding after larger HA reconstruction and sufficient intrahepatic arterial flow was confirmed by Doppler ultrasound (DUS). There was no significant difference in biliary complication rate, artery complication rate, patient survival, and graft survival among these groups. Risk factor analysis revealed that the presence of multiple HAs and partial reconstruction of multiple HAs were not risk factors of biliary anastomosis stricture. In conclusion, partial reconstruction of HAs during pediatric LDLT using a left liver graft with multiple HA stumps does not increase the risk of biliary anastomosis stricture or affect graft survival when intrahepatic arterial communication is confirmed by pulsatile back-bleeding and DUS.
Department of Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
Kyo Won
KW
Lee
Department of Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
Sanghoon
S
Lee
Department of Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
Dong Kyu
DK
Oh
Department of Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
Byung Gon
BG
Na
Department of Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
Jin Yong
JY
Choi
Department of Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
Wontae
W
Cho
Department of Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
Seunghwan
S
Lee
Department of Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
Jong Man
JM
Kim
Department of Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
Gyuseong
G
Choi
Department of Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
Choon Hyuck David
CH
Kwon
Department of Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
Jae-Won
JW
Joh
Department of Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
Suk-Koo
SK
Lee
D000017:ABO Blood-Group System; D000714:Anastomosis, Surgical; D001652:Bile Ducts / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D006499:Hepatic Artery / Q000601:surgery*; D006801:Humans; D007223:Infant; D008099:Liver / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D019737:Transplants; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures
D000017:ABO Blood-Group System
bile duct complication; hepatic artery complication; multiple artery; pediatric liver transplantation