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Experiences of Microsurgical Reconstruction for Variant Hepatic Artery in Living Donor Liver Transplantation

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Abstract

There is an emergent need for improving the microsurgical technique of variant arterial anastomosis to reduce the often seen surgery-related complications. We describe in this article our experience in improving this technique, in 73 living donor liver grafts (64 right lobes, 9 left lobes) in patients with end-stage liver disease during living donor liver transplantation. The hepatic arteries were evaluated preoperatively with computed tomography and magnetic resonance angiography. In this series, 13 grafts (17.80 %) with variant hepatic artery were conducted arterioplasty on a back-table under a loupe or a high-power microscope, which included one recipient in situ interposition vessel graft of recipient proper hepatic artery for artery reconstruction. The back-table reconstruction time was 16 ± 5.6 min. No arterial thrombosis was found in these cases during the 6-month postoperative follow-up. On the basis of our experience, we suggest that back-table microsurgical plasty for graft with arterial variation should be applied to minimize operative difficulties and to avoid arterial complications in living donor liver transplantation.

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Abbreviations

LDLT:

Living donor liver transplantation

HAT:

Hepatic artery thrombosis

HAS:

Hepatic artery stenosis

GRWR:

Graft–recipient weight ratio

IVC:

Inferior vena cava

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Acknowledgments

This study was funded by the Chinese National Natural Scientific Foundations (30740093 and 81070383).

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No commercial associations that might pose a conflict of interest in connection with the submitted manuscript exist.

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Authors and Affiliations

  1. Department of Hepatobiliary Surgery, Chinese PLA Postgraduate Medical School, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China

    Yurong Liang, Sheng Ye, Xianjie Shi, Wenbin Ji, Weidong Duan, Ying Luo & Jiahong Dong

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  1. Yurong Liang
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  2. Sheng Ye
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  3. Xianjie Shi
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  4. Wenbin Ji
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  6. Ying Luo
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  7. Jiahong Dong
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Correspondence to Jiahong Dong.

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Liang, Y., Ye, S., Shi, X. et al. Experiences of Microsurgical Reconstruction for Variant Hepatic Artery in Living Donor Liver Transplantation. Cell Biochem Biophys 65, 257–262 (2013). https://doi.org/10.1007/s12013-012-9421-7

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