Single artery reconstruction in left liver transplantation

• Published in: Surgery 2011-06, Vol.149 (6), p.841-845
• Main Authors: Sugawara, Yasuhiko, MD, Tamura, Sumihito, MD, Kaneko, Junichi, MD, Iida, Takuya, MD, Mihara, Makoto, MD, Makuuchi, Masatoshi, MD, Koshima, Isao, MD, Kokudo, Norihiro, MD
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Constriction, Pathologic - epidemiology; Female; General aspects; Graft Survival - physiology; Hepatic Artery - physiology; Hepatic Artery - surgery; Hepatitis C - surgery; Humans; Incidence; Liver - blood supply; Liver - physiology; Liver - surgery; Liver Cirrhosis, Biliary - surgery; Liver Failure, Acute - surgery; Liver Transplantation - methods; Liver, biliary tract, pancreas, portal circulation, spleen; Living Donors; Male; Medical sciences; Middle Aged; Retrospective Studies; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Thrombosis - epidemiology; Treatment Outcome; Vascular Surgical Procedures - methods; Young Adult
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/j.surg.2010.11.016

Background A left liver graft in living donor liver transplantation often has 2 arterial stumps. The indication for multiple arterial reconstructions remains controversial. The aim of this retrospective study was to investigate whether single anastomosis of a left liver graft affects the outcome of living donor liver transplantation. Methods When a hepatic graft had 2 arterial stumps, the thicker (dominant) stump was reconstructed first. After the initial reconstruction, another reconstruction was performed only if no pulsating flow was observed from the remnant stump. A total of 134 left liver grafts were divided into 3 groups: Group 1 ( n  = 70), 1 arterial stump on a graft with 1 arterial reconstruction; Group 2 ( n = 59), 2 stumps with 1 arterial reconstruction; Group 3 ( n = 5), 2 stumps with 2 arterial reconstructions. The incidence of hepatic arterial thrombosis, biliary stenosis, and patient survival was compared between Groups 1 and 2. Results The incidence of arterial thrombosis and biliary stenosis, and the patient survival curves, were equivalent between Groups 1 and 2. Conclusion When the criteria were satisfied, single arterial reconstruction in a left liver graft with 2 arterial stumps did not affect the patient survival or biliary complications.