[Uncommon arterial and venous reconstruction in liver transplantation]

The aim of this work was to define the best technical options of reconstruction that we can proposed in front of an anatomical or parietal anomalies of venous or arterial system in hepatic transplantation. Through a retrospective study of 10 reconstructions performed between 1978 and 1989, we observed 5 cases of right hepatic artery from superior mesenteric artery of the donor. The two basic methods of reconstruction were either the "fold over" technic of Gordon or the realization of an end to end anastomosis between donor's right hepatic artery and donor's splenic artery. In 3 cases, the insufficiency of the hepatic arterial blood flow after classic anastomosis, led us to employ an arterial iliac graft between the recipient's aorta and the donor's coeliac patch. 2 patients with portocaval shunt or portal parietal defect underwent reconstruction by venous iliac graft. In conclusion, we emphasize the importance of a perfect reconstructed reconstruction as much on the anatomical level than functional.