A no-ligation technique to prevent intraoperative hepatic artery dissection in living-donor liver transplantation

Shinji Itoh, Tomoharu Yoshizumi, Noboru Harada, Takeo Toshima, Yoshihiro Nagao, Takeshi Kurihara, Huanlin Wang, Tomonari Shimagaki, Toru Ikegami, Masaki Mori

Research output: Contribution to journalArticlepeer-review

Abstract

Intrahepatic recipient hepatic artery dissection caused by hepatic artery thrombosis is a lethal complication of living-liver donor liver transplantation (LDLT). We herein report a new surgical technique that avoids the ligation of the recipient hepatic arteries in LDLT. Patients undergoing LDLT between 2009 and 2019 were evaluated. In the second half of this period, a technique involving no ligation of the recipient hepatic artery was initiated and its impact on the incidence of intrahepatic recipient hepatic artery dissection was determined. The middle and left hepatic arteries were ligated in 195 cases (53.4%), and the no-ligation technique was used in 170 (46.6%). The incidence of intraoperative hepatic artery dissection was significantly lower in the no-ligation group (n = 0, 0.0%) than in the ligation group (n = 10, 5.1%) (p = 0.0021). After propensity score matching to evaluate the patient characteristics, the incidence of intraoperative hepatic artery dissection was also significantly lower in the no-ligation group (n = 0, 0.0%) than in the ligation group (n = 6, 4.5%) (p = 0.0295). As a result, this new surgical technique is highly recommended to avoid recipient hepatic artery ligation in LDLT.

Original languageEnglish
JournalSurgery today
DOIs
Publication statusAccepted/In press - 2021

All Science Journal Classification (ASJC) codes

  • Surgery

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