Hepatic Artery Reconstruction With Autologous Inferior Mesenteric Artery Graft in Living Donor Liver Transplant Recipients.
BACKGROUND
In living donor liver transplantation (LDLT), hepatic arterial continuity is crucial to avoid biliary leakage, biliary stricture, cholangitis, and graft and patient loss. Sometimes there exist factors making anastomosis difficult or even impossible. In these cases, a vascular graft may be needed to bridge the two arteries for revascularization.


METHODS
Medical records of 297 patients who underwent LDLT between June 2000 and July 2016 at the Hepatopancreatobiliary Surgery and Liver Transplantation Unit of Dokuz Eylul University Hospital were reviewed retrospectively. Twenty-eight (9%) patients younger than the age of 18 were excluded from the study. The remaining 269 patients were included in the study. We analyzed data of patients who developed hepatic arterial complications during or after LDLT and underwent revascularization using autologous interposed inferior mesenteric artery (IMA) grafts.


RESULTS
In 8 (2.9%) of the 269 patients who underwent LDLT and were included in the study, autologous interposed IMA grafts were used for the hepatic artery revascularization. All of the patients were males. Their mean age was 42 (range, 25-57). The mean duration of follow-up was 83.25 months (range, 3-144 months). One patient developed intraoperative hepatic arterial thrombosis (HAT) after autologus IMA reconstruction and this patient needed retransplantation. No arterial complications developed in the other 7 patients.


CONCLUSIONS
Autologous interposed IMA graft could be used as an alternative vascular graft in hepatic artery revascularization to provide tension-free hepatic arterial continuity.
Department of General Surgery, Dokuz Eylul University School of Medicine, İzmir, Turkey. Electronic address: mucahitozbilgin@gmail.com.
M
M
Özbilgin
Department of General Surgery, Dokuz Eylul University School of Medicine, İzmir, Turkey.
T
T
Ünek
Department of General Surgery, Dokuz Eylul University School of Medicine, İzmir, Turkey.
T
T
Egeli
Department of General Surgery, Dokuz Eylul University School of Medicine, İzmir, Turkey.
C
C
Ağalar
Department of Anaesthesiology and Intensive Care, Dokuz Eylul University School of Medicine, İzmir, Turkey.
S
S
Ozkardesler
Department of Radiology, Dokuz Eylul University School of Medicine, İzmir, Turkey.
F
F
Obuz
Department of Medical Informatics and Biostatistics, Dokuz Eylul University School of Medicine, İzmir, Turkey.
H
H
Ellidokuz
Department of General Surgery, Dokuz Eylul University School of Medicine, İzmir, Turkey.
S
S
Karademir
Department of General Surgery, Dokuz Eylul University School of Medicine, İzmir, Turkey.
I
I
Astarcıoğlu
D000328:Adult; D064592:Autografts / Q000098:blood supply; D006499:Hepatic Artery / Q000601:surgery*; D006801:Humans; D008107:Liver Diseases / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D017537:Mesenteric Artery, Inferior / Q000637:transplantation*; D008875:Middle Aged; D012086:Reoperation / Q000009:adverse effects; D012189:Retrospective Studies; D013927:Thrombosis / Q000209:etiology / Q000601:surgery; D066027:Transplant Recipients; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods