A novel technique for hepatic arterial reconstruction in living-donor liver transplant

Arterial reconstruction in patients undergoing living-donor liver transplant is technically difficult because of the small diameter of the vessels in the partial liver graft. In this study, we present our technique for hepatic arterial reconstruction.

Since December 2005, we have performed 54 living-donor liver transplants, which are analyzed retrospectively in this report. In our technique now used at our institution, native and graft hepatic arteries are spatulated from both the anterior and posterior walls to provide a wide anastomosis. Computed tomographic angiography is used to evaluate the vascular anatomy and to measure the diameter of the graft hepatic arteries.

Mean follow-up was 7.2 +/- 5.5 months (range, 1-17 months). Nine of the 54 recipients died within 4 months of the surgery. At the time of this writing, the remaining 45 recipients (84%) are alive and demonstrating good graft function. In 2 recipients (3.7%) in this series, hepatic artery thromboses developed, which were treated with an interventional radiologic technique.

Our arterial reconstruction technique has enabled reconstruction of smaller arteries and arteries of various diameters without an operating microscope. The rate of complications in our patients is similar to that reported in similar individuals.