TY - JOUR
T1 - A no-ligation technique to prevent intraoperative hepatic artery dissection in living-donor liver transplantation
AU - Itoh, Shinji
AU - Yoshizumi, Tomoharu
AU - Harada, Noboru
AU - Toshima, Takeo
AU - Nagao, Yoshihiro
AU - Kurihara, Takeshi
AU - Wang, Huanlin
AU - Shimagaki, Tomonari
AU - Ikegami, Toru
AU - Mori, Masaki
N1 - Funding Information:
This study was supported by the following grant: JSPS KAKENHI, a Grant-in-Aid from the Ministry of Health, Labour and Welfare, Japan (Numbers JP-19K09198). The funding source had no role in the collection, analysis, or interpretation of the data or in the decision to submit the article for publication.
Publisher Copyright:
© 2021, Springer Nature Singapore Pte Ltd.
PY - 2021/11
Y1 - 2021/11
N2 - 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.
AB - 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.
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U2 - 10.1007/s00595-021-02276-8
DO - 10.1007/s00595-021-02276-8
M3 - Article
C2 - 33796918
AN - SCOPUS:85103829312
VL - 51
SP - 1877
EP - 1880
JO - Surgery Today
JF - Surgery Today
SN - 0941-1291
IS - 11
ER -