Extra-Anatomic Jump Graft Arterial Reconstruction Using a Great Saphenous Vein Autograft During Living Donor Liver Transplantation

Transplant Proc. 2019 Nov;51(9):3120-3123. doi: 10.1016/j.transproceed.2019.07.004. Epub 2019 Oct 11.

Abstract

Background: In living-donor liver transplantation (LDLT), successful microsurgical arterial reconstruction is essential but quite challenging. Dissection of the hepatic artery extending to the celiac trunk is a rare complication during liver transplantation. Kazakhstan is an area in which deceased donor grafts are not sufficient for several reasons, and the availability of graft vessels is limited.

Methods: We herein report the case of a 65-year-old patient who underwent LDLT due to hepatitis B + D virus-coinfected liver cirrhosis complicated by hepatic artery dissection extending to the celiac trunk. Because of massive gastric collateral varices, direct anastomosis to the supraceliac aorta was not possible. Therefore, extra-anatomic jump graft reconstruction was performed from the right iliac artery to the graft's hepatic artery using an autologous graft vein (great saphenous vein).

Results: The patient's postoperative period was uneventful. The patient was discharged at 27 days post-transplantation. At the time of writing, the follow-up period is 8 months after transplantation, and the recipient maintains a normal liver function.

Conclusion: When there is no other option for arterial reconstruction, this method is a feasible option for performing extra-anatomic jump graft reconstruction.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Aortic Dissection / surgery
  • Female
  • Hepatic Artery / pathology
  • Humans
  • Liver Transplantation / methods*
  • Living Donors
  • Male
  • Middle Aged
  • Plastic Surgery Procedures / methods*
  • Saphenous Vein / transplantation*
  • Transplantation, Autologous / methods
  • Vascular Surgical Procedures / methods*