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Splenic Artery Transposition for Arterial Reconstruction in Living Donor Liver Transplantation.
Metadata
Journaltransplantation proceedings0.784Date
2020 Jun 03
4 months ago
Type
Journal Article
Volume
2020-Jun-03 / :
Author
Alim A 1, Dayangac M 1, Erdogan Y 1, Malamutmann E 2, Yuzer Y 1, Tokat Y 1, Oezcelik A 3
Affiliation
  • 2. Department of General, Visceral and Transplantation Surgery, University Hospital of Essen, Essen, Germany.
  • 3. Department of General and Transplantation Surgery, University Hospital of the Istanbul Bilim University, Istanbul, Turkey; Department of General, Visceral and Transplantation Surgery, University Hospital of Essen, Essen, Germany. Electronic address: [email protected]
Doi
PMIDMESH
Abstract
PURPOSE: In living donor liver transplantation, poor compatibility of the recipient hepatic artery remains a technical challenge. Here, we analyzed our 14 years of experience with extra-anatomic hepatic artery reconstruction.
METHODS: Between July 2004 and December 2018, there were 1063 liver transplantations at our center. All patients with an extra-anatomic hepatic artery reconstruction were identified. The gastroduodenal artery and the transposed splenic artery were the primary options for extra-anatomic arterial reconstruction. Patient characteristics, operative data, and post-transplant outcome were reviewed retrospectively.
RESULTS: There were 22 patients with extra-anatomic hepatic artery reconstruction, 6 with gastroduodenal artery, and 16 with splenic artery. There were 2 major complications: 1 patient underwent early reoperation due to bleeding from the splenic artery trunk and another had an iatrogenic injury to the transposed splenic artery during conversion hepaticojejunostomy. Both were treated successfully with surgery. One patient died perioperatively due to sepsis. The 1- and 3-year graft survival rates of these 16 patients were 93.7% and 87.5%.
CONCLUSION: If the hepatic arteries are not suitable for anastomosis, then we consider the gastroduodenal artery and the splenic artery to be the conduits of choice for extra-anatomic arterial reconstruction. The transposed splenic artery is very consistent, easily accessible, and offers adequate length and diameter for successful arterial anastomosis.
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Transplant Proctransplantation proceedings
Metadata
LocationUnited States
FromELSEVIER SCIENCE INC

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