Minimizing and Managing Hepatic Artery and Biliary Complications in Pediatric Liver Transplantation

Pediatric liver transplantation (PLT) is a technically demanding procedure with hepatic artery (HA) and biliary reconstruction representing critical determinants of outcomes. This review synthesizes current strategies for minimizing and managing HA and biliary complications in PLT, emphasizing the impact of surgical technique, microsurgical precision, and intraoperative decision-making on graft and patient survival. Key considerations include the use of loupe or operating microscope magnification, individualized anticoagulation protocols, and tailored management of complications such as hepatic artery thrombosis and biliary strictures. The manuscript also highlights the evolving role of interventional radiology and innovative approaches for biliary reconstruction, underscoring the importance of multidisciplinary care for optimizing long-term results.