Single-Center Experience of Consecutive 522 Cases of Hepatic Artery Anastomosis in Living-Donor Liver Transplantation

Transplant Proc. 2015 Jul-Aug;47(6):1905-11. doi: 10.1016/j.transproceed.2015.06.014.

Abstract

Objective: The aim of this study was to clarify risk factors and outcome of hepatic arterial complication after living-donor liver transplantations (LDLT).

Methods: From 2004 to 2010, 522 consecutive LDLTs were performed. We used univariate and multivariate analysis to identify the risk factor on a retrospective basis, and then analysis was performed for adult cases. Hepatic arterial complication included thrombosis, stenosis, and pseudoaneurysm.

Results: The arterial complication rate was 4.79% (25 cases). Each complication was 9 thromboses, 14 stenoses, and 2 pseudoaneurysms. Preoperative hemoglobin was significantly associated with thrombosis (P = .021), and arterial size with stenosis (P = .037). We could not find any association between arterial complications and biliary stricture. However, the outcome of biliary stricture treatment was associated with arterial stenosis. Of 9 cases with thrombosis, 7 patients underwent rearterialization and 2 were treated with low-molecular-weight heparin (LMWH). Of 14 stenosis cases, 2 patients were treated with the use of balloon dilatation, 10 patients were observed under LMWH, and 2 patients underwent retransplantation. In cases of pseudoaneurysm, 1 patient underwent revision of the aneurysm and the other was observed.

Conclusions: In our cohort, preoperative low hemoglobin level was a risk factor for thrombosis and artery size a risk factor for stenosis.

MeSH terms

  • Adult
  • Aged
  • Anastomosis, Surgical / adverse effects*
  • Anticoagulants / therapeutic use
  • Child
  • Female
  • Hemoglobins / analysis
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Hepatic Artery* / anatomy & histology
  • Hepatic Artery* / surgery
  • Humans
  • Liver Transplantation / adverse effects*
  • Liver Transplantation / methods
  • Living Donors
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Postoperative Complications / etiology
  • Reoperation / adverse effects
  • Retrospective Studies
  • Risk Factors
  • Vascular Diseases / etiology*
  • Vascular Diseases / therapy

Substances

  • Anticoagulants
  • Hemoglobins
  • Heparin, Low-Molecular-Weight