Comparison of alternative arterial anastomosis site during liver transplantation when the recipient's hepatic artery is unusable.
Liver transplantation (LT)
arterial anastomosis
hepatic artery (HA)
splenic artery (SA)
Journal
Hepatobiliary surgery and nutrition
ISSN: 2304-3881
Titre abrégé: Hepatobiliary Surg Nutr
Pays: China (Republic : 1949- )
ID NLM: 101600750
Informations de publication
Date de publication:
Feb 2022
Feb 2022
Historique:
received:
06
01
2020
accepted:
13
05
2020
entrez:
14
3
2022
pubmed:
15
3
2022
medline:
15
3
2022
Statut:
ppublish
Résumé
Few studies have analyzed outcomes of liver transplantation (LT) when the recipient hepatic artery (HA) was not usable. We retrospectively evaluated the outcomes of LT performed using the different alternative sites to HA. Between 2002 and 2017, 1,677 LT were performed in our institution among which 141 (8.4%) with unusable recipient HA were analyzed. Four groups were defined according to the site of anastomosis: the splenic artery (SA group, n=26), coeliac trunk (CT group, n=12), aorta using or not the donor's vessel (Ao group, n=91) and aorta using a vascular prosthesis (Ao-P group, n=12) as conduit. The median number of intraoperative red blood cell transfusions was significantly increased in the Ao and Ao-P groups (5, 5, 8.5 and 16 for SA, CT, Ao and Ao-P group respectively, P=0.002), as well as fresh frozen plasma (4.5, 2.5, 10, 17 for the SA, CT, Ao and Ao-P groups respectively, P=0.001). Hospitalization duration was also significantly increased in the Ao and Ao-P groups (15, 16, 24, 26.5 days for the SA, CT, Ao and Ao-P groups respectively, P<0.001). The occurrence of early allograft dysfunction (EAD) (P=0.07) or arterial complications (P=0.26) was not statistically different. Level of factor V, INR, bilirubin and creatinine during the 7 In case of unusable HA, intraoperative and postoperative outcomes are improved when using the SA or CT compared to aorta.
Sections du résumé
Background
UNASSIGNED
Few studies have analyzed outcomes of liver transplantation (LT) when the recipient hepatic artery (HA) was not usable.
Methods
UNASSIGNED
We retrospectively evaluated the outcomes of LT performed using the different alternative sites to HA.
Results
UNASSIGNED
Between 2002 and 2017, 1,677 LT were performed in our institution among which 141 (8.4%) with unusable recipient HA were analyzed. Four groups were defined according to the site of anastomosis: the splenic artery (SA group, n=26), coeliac trunk (CT group, n=12), aorta using or not the donor's vessel (Ao group, n=91) and aorta using a vascular prosthesis (Ao-P group, n=12) as conduit. The median number of intraoperative red blood cell transfusions was significantly increased in the Ao and Ao-P groups (5, 5, 8.5 and 16 for SA, CT, Ao and Ao-P group respectively, P=0.002), as well as fresh frozen plasma (4.5, 2.5, 10, 17 for the SA, CT, Ao and Ao-P groups respectively, P=0.001). Hospitalization duration was also significantly increased in the Ao and Ao-P groups (15, 16, 24, 26.5 days for the SA, CT, Ao and Ao-P groups respectively, P<0.001). The occurrence of early allograft dysfunction (EAD) (P=0.07) or arterial complications (P=0.26) was not statistically different. Level of factor V, INR, bilirubin and creatinine during the 7
Conclusions
UNASSIGNED
In case of unusable HA, intraoperative and postoperative outcomes are improved when using the SA or CT compared to aorta.
Identifiants
pubmed: 35284512
doi: 10.21037/hbsn-20-10
pii: hbsn-11-01-1
pmc: PMC8847870
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1-12Informations de copyright
2022 Hepatobiliary Surgery and Nutrition. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://hbsn.amegroups.com/article/view/10.21037/hbsn-20-10/coif). GBLS serves as an unpaid editorial board member of Hepatobiliary Surgery and Nutrition. The other authors have no conflicts of interest to declare.
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