Dual hepatic artery reconstruction in living donor liver transplantation using a left hepatic graft with 2 hepatic arterial stumps

Hideaki Uchiyama, Noboru Harada, Kensaku Sanefuji, Hiroto Kayashima, Akinobu Taketomi, Yuji Soejima, Toru Ikegami, Mitsuo Shimada, Yoshihiko Maehara

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Abstract

Background: A left hepatic graft in living donor liver transplantation (LDLT) often has 2 thin and short hepatic arterial stumps, which makes hepatic artery (HA) reconstructions much more difficult to perform. Consequently, some investigators regard using a left graft as a contraindication to LDLT, whereas others report that the reconstruction of only 1 HA is sufficient for most LDLTs. The aim of this retrospective study was to investigate whether 2 HAs on a left hepatic graft in an LDLT can be reconstructed safely and whether the outcomes of LDLTs are affected by reconstructing both HAs (dual reconstruction). Methods: A total of 175 LDLTs using a left graft between October 1996 and April 2008 were divided into 3 groups: group 1 (n = 104): 1 HA stump with 1 HA reconstruction; group 2 (n = 47): 2 HA stumps with dual HA reconstruction; and group 3 (n = 24): 2 HA stumps with only 1 HA reconstruction. We reconstructed HAs using microvascular surgical techniques. Results: With technical advancement, we have been able to reconstruct both HAs in most cases without any HA-related complications, despite the fact that complex HA reconstructions were needed. Group 3 patients had a significantly greater incidence of anastomotic biliary stricture, which was decreased by dual HA reconstructions to the same level as observed in group 1. Conclusion: Dual HA reconstructions can be performed safely in LDLTs with a decreased incidence of anastomotic biliary stricture.

Original languageEnglish
Pages (from-to)878-886
Number of pages9
JournalSurgery
Volume147
Issue number6
DOIs
Publication statusPublished - Jun 1 2010

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Living Donors
Hepatic Artery
Liver Transplantation
Transplants
Liver
Pathologic Constriction
Incidence
Retrospective Studies
Research Personnel

All Science Journal Classification (ASJC) codes

  • Surgery

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Dual hepatic artery reconstruction in living donor liver transplantation using a left hepatic graft with 2 hepatic arterial stumps. / Uchiyama, Hideaki; Harada, Noboru; Sanefuji, Kensaku; Kayashima, Hiroto; Taketomi, Akinobu; Soejima, Yuji; Ikegami, Toru; Shimada, Mitsuo; Maehara, Yoshihiko.

In: Surgery, Vol. 147, No. 6, 01.06.2010, p. 878-886.

Research output: Contribution to journalArticle

Uchiyama, Hideaki ; Harada, Noboru ; Sanefuji, Kensaku ; Kayashima, Hiroto ; Taketomi, Akinobu ; Soejima, Yuji ; Ikegami, Toru ; Shimada, Mitsuo ; Maehara, Yoshihiko. / Dual hepatic artery reconstruction in living donor liver transplantation using a left hepatic graft with 2 hepatic arterial stumps. In: Surgery. 2010 ; Vol. 147, No. 6. pp. 878-886.
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AU - Taketomi, Akinobu

AU - Soejima, Yuji

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