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Impact of hepatic artery size mismatch between donor and recipient on outcomes after living‐donor liver transplantation using the right lobe
Author(s) -
Harada Noboru,
Yoshizumi Tomoharu,
Uchiyama Hideaki,
Soejima Yuji,
Ikegami Toru,
Itoh Shinji
Publication year - 2019
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13444
Subject(s) - medicine , anastomosis , stenosis , living donor liver transplantation , liver transplantation , artery , surgery , transplantation , lobe , surgical anastomosis , gastroenterology , risk factor , anatomy
The aim of this study was to evaluate the effect of hepatic artery (HA) size mismatch anastomosis on outcomes after living‐donor liver transplantation (LDLT). Materials and methods After excluding 128 patients with the exclusion criteria among 233 LDLTs using the right lobe, 104 LDLT patients were divided into two groups: donor HA diameter that was greater than or equal to the recipient HA diameter (D ≥ R group; n = 79), and donor HA diameter that was smaller than the recipient HA diameter (D < R group; n = 25). Results Hepatic artery‐related complications occurred in only one patient (HA thrombosis; 1.0%) who was in the D < R group. The reconstructed HA flow in the D ≥ R group was significantly greater than that in the D < R group ( P = 0.015). There was a higher incidence of anastomotic biliary stricture in the D < R group (32.0%) compared with the D ≥ R group (13.9%, P = 0.022) after LDLT. A multivariate analysis with Cox regression revealed that the HA anastomosis of the D < R group and hepaticojejunostomy were significant independent risk factors for postoperative anastomotic biliary stenosis. Conclusions Hepatic artery anastomosis with a donor HA diameter smaller than that of the recipient HA might be an independent risk factor for postoperative biliary stenosis after LDLT using the right lobe.