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.
journal_name
Surgeryjournal_title
Surgeryauthors
Uchiyama H,Harada N,Sanefuji K,Kayashima H,Taketomi A,Soejima Y,Ikegami T,Shimada M,Maehara Ydoi
10.1016/j.surg.2009.06.028subject
Has Abstractpub_date
2010-06-01 00:00:00pages
878-86issue
6eissn
0039-6060issn
1532-7361pii
S0039-6060(09)00410-3journal_volume
147pub_type
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