J Korean Soc Plast Reconstr Surg.  2009 Jan;36(1):33-37.

Hepatic Artery Anastomosis in Liver Transplantation

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, School of Medicine, Ajou University, Suwon, Korea. mpark@ajou.ac.kr
  • 2Department of Surgery, School of Medicine, Ajou University, Suwon, Korea.

Abstract

PURPOSE
Liver transplantation is considered as the treatment of choice in many acute and chronic liver diseases, and it is becoming more common. Since successful microscopic anastomosis of hepatic artery is a crucial requirement of successful liver transplantation, we studied and analyzed the result of hepatic artery anastomosis of liver transplantation in our liver transplantation center.
METHODS
145 liver transplantations were performed from February 2005 to May 2008. Male to female ratio of the liver transplantation recipients was 3.4:1. Anastomosis of portal vein, hepatic vein and biliary tract was performed by the general surgeon, and anastomosis of hepatic artery was performed by the plastic surgeon under the loupe or microscopic vision. After the hepatic artery was reconstructed, anastomosed site status and flow were checked with Doppler ultrasonography intraoperatively and with contrast enhanced CT or angiography postoperatively if necessary.
RESULTS
Out of 145 liver transplantations, cadaveric liver donor was used 37 cases and living donor liver transplantation was performed 108 cases including the 2 dual donor liver transplantations. As for the baseline diseases that resulted in the liver transplantation, there were 57 cases of liver cirrhosis and hepatocellular carcinoma due to hepatitis B, taking up the greatest proportion. Single donor hepatic artery was used in 114 cases, and mean artery diameter was 2.92mm and mean artery length was 24.25mm. Hepatic artery was used as the recipient artery in every case except the 8 cases in which gastroepiploic artery was used as alternative. Out of 145 cases of hepatic artery anastomosis, 3 cases resulted in the thrombosis of the hepatic artery, requiring thrombectomy and re-anastomosis. In all 3 cases, thrombosis was found in left hepatic artery and there was no past history of hepatic artery chemoembolization.
CONCLUSION
Incidence of hepatic artery thrombosis after the anastomosis of hepatic artery during liver transplantation was 2.1%, which is considered sufficiently low.

Keyword

Liver transplantation; Hepatic artery anastomosis; Hepatic artery thrombosis

MeSH Terms

Angiography
Arteries
Biliary Tract
Cadaver
Carcinoma, Hepatocellular
Female
Gastroepiploic Artery
Hepatic Artery
Hepatic Veins
Hepatitis B
Humans
Incidence
Liver
Liver Cirrhosis
Liver Diseases
Liver Transplantation
Living Donors
Male
Portal Vein
Thrombectomy
Thrombosis
Tissue Donors
Ultrasonography, Doppler
Vision, Ocular
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