LAUSR.org creates dashboard-style pages of related content for over 1.5 million academic articles. Sign Up to like articles & get recommendations!

Comparison of reconstruction methods used during liver transplantation in case of a graft with replaced or accessory right hepatic artery: a retrospective study.

Photo from wikipedia

Variations in graft arterial anatomy can increase the risk of postoperative hepatic arterial thrombosis (HAT), especially in presence of a replaced or accessory right hepatic artery (RHA). We retrospectively analysed… Click to show full abstract

Variations in graft arterial anatomy can increase the risk of postoperative hepatic arterial thrombosis (HAT), especially in presence of a replaced or accessory right hepatic artery (RHA). We retrospectively analysed 223 cases of liver transplantations with the presence of a RHA on the graft. Patient outcomes were compared according to the 4 different reconstruction methods used: i)the re-implantation of the RHA into the splenic or gastroduodenal artery (n=106); ii)the interposition of the superior mesenteric artery (SMA) (n=83); iii)dual anastomosis (n=24); iv)use of an aortic patch including the origins of both the SMA and the coeliac trunk (n=10). A competing risk analysis and Inverse Probability Weighting(IPW) were used. We found that the interposition of the SMA method was associated with a significantly lower incidence of HAT, at 4.8% compared to the re-implantation method at 17.9%, dual anastomosis at 12.5% and aortic patch at 20%, p=0.03. In the competing risk analysis with IPW, the only risk factor for RHA thrombosis was the type of reconstruction. Taking the SMA interposition group as the reference, the sub-hazard ratio (sHR) was 5.05 (CI95[1.72 ; 14.78], p<0.01) for the re-implantation group, sHR=2.37 (CI95[0.51 ; 11.09], p=0.27) for the dual anastomosis group and sHR=2.24 (CI95 [0.35 ; 14.33], p=0.40) for the aortic patch group. There were no differences for intraoperative transfusion, hospitalization duration (p=0.37) or incidence of severe complications (p=0.1). The long-term graft (p=0.69) and patient (p=0.52) survival was not different. In conclusion, the SMA interposition method was associated with a lower incidence of RHA thrombosis.

Keywords: artery; accessory right; right hepatic; replaced accessory; reconstruction; graft

Journal Title: Journal of hepato-biliary-pancreatic sciences
Year Published: 2022

Link to full text (if available)


Share on Social Media:                               Sign Up to like & get
recommendations!

Related content

More Information              News              Social Media              Video              Recommended



                Click one of the above tabs to view related content.