Arterial Inflow Techniques

  • Anya Adair
  • Gabriel C. OniscuEmail author
Part of the Springer Surgery Atlas Series book series (SPRISURGERY)


Restoring adequate arterial inflow to the donor liver is essential for graft function, the health of the biliary tree, and the long-term survival of the graft. Hepatic artery thrombosis (HAT) has a significant impact on the rate of postoperative morbidity, mortality, graft loss, and the need for retransplantation. The incidence of HAT reported in the literature ranges from 2.5% to 8% [1–3]. The transplanted liver is particularly dependent on the hepatic artery, as any potential collateral supply existing in the native liver is severed at the time of hepatectomy [5]. Common variations of hepatic arterial anatomy include accessory or replaced right hepatic artery from the superior mesenteric artery (SMA), accessory or replaced left hepatic artery from the left gastric artery, or a completely replaced hepatic arterial system from the SMA (Fig. 8.1). During the donor retrieval operation, it is essential to recognize the hepatic artery variations. Back-table reconstruction then must be performed to provide optimal arterial supply to the graft [8, 9], but this reconstruction should be undertaken by the implanting surgeon rather than at the retrieval hospital.


Arterial anastomosis Hepatic artery Donor artery Arterial jump graft 


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© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Scottish Liver Transplant UnitEdinburgh Transplant CentreEdinburghUK
  2. 2.Edinburgh Transplant Centre, The Royal Infirmary of EdinburghUniversity of EdinburghEdinburghUK

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