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Hepatic artery reconstruction and successful management of its complications in living donor liver transplantation using a right lobe
Author(s) -
Kim SayJune,
Yoon YoungChul,
Park JungHyun,
Oh DeukYoung,
Yoo YoungKyung,
Kim DongGoo
Publication year - 2011
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/j.1399-0012.2010.01385.x
Subject(s) - medicine , surgery , transplantation , liver transplantation , anastomosis , stenosis , pseudoaneurysm , thrombosis , artery , thrombolysis , complication , portal vein thrombosis , radiology , myocardial infarction
Kim S‐J, Yoon Y‐C, Park J‐H, Oh D‐Y, Yoo Y‐K, Kim D‐G. Hepatic artery reconstruction and successful management of its complications in living donor liver transplantation using a right lobe.
Clin Transplant 2011: 25: 929–938. © 2010 John Wiley & Sons A/S. Abstract: Background: The aim of the present study was to improve the techniques of hepatic artery (HA) reconstruction and to properly manage arterial complications after living donor liver transplantation (LDLT). Methods: Prospectively collected data collected from 371 patients who underwent adult LDLT using a right lobe from January 2000 to August 2009 were retrospectively reviewed. Results: Of 17 patients (4.6%, 17/371) with double HA stumps in the graft, 12 patients (70.6%) received dual HA reconstruction. HA complications were composed of thrombosis (n = 6), pseudoaneurysm (n = 2), and stenosis (n = 4), showing 3.2% (12/371) of incidence. In patients with HA thrombosis, whereas operative thrombectomies with re‐anastomosis rescued all the grafts in early attack (n = 3, ≤1 wk), angiographic thrombolysis successfully reestablished the flow in patients with late attack (n = 3, >1 wk). In all patients with HA complications, except for one, all of our treatment modalities – operation and angiographic intervention – resulted in successful rescue of grafts and no patient received re‐transplantation because of HA complications. Conclusion: Prompt diagnosis of HA complications by serial post‐operative Doppler ultrasound and corresponding treatment strategies, including operative and radiological intervention, can rescue both grafts and patients without necessitating re‐transplantation.