title: Outcome of living donor liver transplantation using right liver allografts with multiple arterial supply.
abstract: A right liver graft with multiple hepatic artery (HA) stumps can be found in approximately 5% of living donor liver transplantation (LDLT) using a right lobe graft. From January 2000 to June 2014, 1149 patients underwent LDLT procedures. Thirty patients with LDLT using a right lobe graft with multiple HA stumps and 149 patients with LDLT using a right lobe graft with a single HA stump were enrolled. These patients were divided into 3 groups: single HA (group 1, n = 149), multiple HAs with total reconstruction (group 2, n = 19), and multiple HAs with selective partial reconstruction (group 3, n = 11). Selective partial reconstruction was performed only when pulsatile back-bleeding was confirmed after larger HA reconstruction and sufficient intrahepatic arterial flow was confirmed by Doppler ultrasound (DUS). In group 2, the donor HAs were smaller (P < .001), and HA reconstruction took longer (P < .001). However, there was no significant difference among the groups regarding the arterial complication rate, biliary complication rate, and patient and graft survival. In conclusion, selective partial reconstruction of HA stumps for LDLT using a right lobe graft was feasible when intrahepatic arterial communication was confirmed by pulsatile back-bleeding from the smaller artery and DUS. Liver Transplantation 22 1649-1655 2016 AASLD.
authors: Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Kyo Won
authors: KW
authors: Lee
authors: Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Sanghoon
authors: S
authors: Lee
authors: Department of Surgery, Guro Sungsim Medical Center, Seoul, Korea.
authors: Jeungmin
authors: J
authors: Huh
authors: Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Chan Woo
authors: CW
authors: Cho
authors: Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Nuri
authors: N
authors: Lee
authors: Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea.
authors: Hye Seung
authors: HS
authors: Kim
authors: Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea.
authors: Kyunga
authors: 0000-0002-0865-2236
authors: K
authors: Kim
authors: Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Jong Man
authors: JM
authors: Kim
authors: Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Gyu Seong
authors: GS
authors: Choi
authors: Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Choon Hyuck David
authors: CH
authors: Kwon
authors: Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Jae-Won
authors: JW
authors: Joh
authors: Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Suk-Koo
authors: SK
authors: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D064591:Allografts / Q000098:blood supply*; D000714:Anastomosis, Surgical; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006499:Hepatic Artery / Q000601:surgery*; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D014184:Transplantation, Homologous / Q000379:methods; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult