title: A New Consideration in Hepatic Artery Reconstruction in Adult Liver Transplant: Arterial Transposition Versus Extra-Anatomic Jump Grafts.
abstract: OBJECTIVE
  In some cases of liver transplant, standard hepatic artery reconstruction may be difficult or impossible due to inadequate flow of the recipient's hepatic artery, as a result of stenosis, intimal dissection, or anomalies of the hepatic artery. We compared splenic artery transposition with extra-anatomic jump graft as 2 alternative methods for hepatic artery reconstruction in these situations.
  
  
  METHODS
  We reviewed the files of 2135 liver transplant recipients from March 2011 to February 2016 at the Shiraz Transplant Center. Data of 93 patients with unusual hepatic artery reconstruction were analyzed to assess outcomes, morbidity, mortality, and pre- and posttransplant parameters (both clinical and paraclinical). Patients were divided into 2 groups: 17 with splenic artery transposition (splenic artery group) and 76 with extra-anatomic jump grafts (control group).
  
  
  RESULTS
  There was only 1 occurrence (5.8%) of hepatic artery thrombosis in the splenic artery group causing extra-anatomic jump graft. However, in the control group, there were 4 occurrences (5.2%) of hepatic artery thrombosis, causing 1 revision of anastomosis and 3 retransplant procedures. No deaths due to hepatic artery complications were reported in the 2 groups. Three-year survival rate was 87.5% in the splenic artery group and 68.9% in the control group.
  
  
  CONCLUSIONS
  Splenic artery transposition is an acceptable method for hepatic artery reconstruction in deceased-donor liver transplant procedures with no greater rates of complication or morbidity than extra-anatomic jump grafts. Less operation time and better exposure during surgery are advantages of this method.
authors.affiliation: Department of Organ Transplantation, Namazi Hospital, Shiraz, Iran.
authors.forename: Kourosh
authors.initials: K
authors.lastname: Kazemi
authors.forename: Pirooz
authors.initials: P
authors.lastname: Samidoost
authors.forename: Hamed Nikoupour
authors.initials: HN
authors.lastname: Deilami
authors.forename: Seyed Ali
authors.initials: SA
authors.lastname: Malek Hosseini
authors.forename: Saman
authors.initials: S
authors.lastname: Nikeghbalian
authors.forename: Alireza
authors.initials: A
authors.lastname: Shamsaeefar
authors.forename: Masood
authors.initials: M
authors.lastname: Dehghani
authors.forename: Mohsenreza
authors.initials: M
authors.lastname: Mansoorian
authors.forename: Siavash
authors.initials: S
authors.lastname: Gholami
authors.forename: Bahareh
authors.initials: B
authors.lastname: Khosravi
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology; D006499:Hepatic Artery / Q000601:surgery*; D006801:Humans; D007083:Iliac Artery / Q000637:transplantation*; D007492:Iran; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000401:mortality; D012307:Risk Factors; D013157:Splenic Artery / Q000601:surgery*; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult