Hepatic Artery Anastomosis

Abstract

Hepatic Arterial Anastomosis is the most important procedure in living donor liver transplantation. For optimal stump function, it is critical to ensure meticulous and atraumatic dissection of hepatic hilum in both the donor and recipient operations. A partial graft artery is small and thin, especially with multiple arteries. Therefore, a precise anastomotic technique is required for safe anastomosis with a surgical microscope or loupes. In the recipient hilar dissection, each of the arterial stumps is identified up to at least the second branches for size matching with the donor arterial stumps. Interrupted or continuous anastomotic techniques are commonly used with several modifications. For stumps that are too short, the backwall first technique is useful, and this was done here without stump rotation. It is preferable to subject all graft arterial stumps to anastomosis if possible. Following anastomosis, doppler ultrasonography is performed to evaluate the patency. In the case of arterial thrombosis, early re-anastomosis with different health inflow is essential for graft saving.