Abstract:
Objectives: We aimed to examine management of
double hepatic artery reconstruction in patients
under going living-donor liver transplant.
Materials and Methods: Between January 2002 and
June 2014, one thousand thirty-six living-donor liver
transplants were performed at the Liver Transplant
Institute of Malatya Inonu University. Living liver
grafts with a single hepatic artery were used in 983
living-donor liver transplants, while grafts with
double hepatic artery branches were used in 53 livingdonor
liver transplants. All of the liver grafts with
double hepatic artery branches were right lobe grafts.
Hepatic artery anastomosis technique and the other
medical data of recipients who used grafts with
double hepatic arteries were analyzed retrospectively.
Results: A double hepatic artery anastomosis was
created in 43 recipients, while a single anastomosis
was created in the remaining 10 because of ligation
of the nondominant hepatic artery branch. In 40
recipients, double hepatic artery branches in the
graft were anastomosed with the recipient’s right
and left hepatic artery. In the remaining 3 recipients,
double hepatic artery branches in the graft were
anastomosed with the recipient’s right hepatic artery
and large segment 4 hepatic arteries. Postoperative
complications related with hepatic artery anastomoses
developed in 3 recipients: hepatic artery
thrombosis (n = 1), hepatic artery aneurysm (n = 1),
and hepatic artery stenosis (n = 1). A recipient with hepatic artery aneurysm immediately underwent a
retransplant. A recipient with a hepatic artery
thrombosis relapsed and required retransplant, which
was treated with thrombectomy on postoperative
day 10. A recipient with hepatic artery stenosis was
followed conservatively. In our series, the incidence
of complications related with double hepatic artery
anastomosis was found to be 6.9%.
Conclusions: According to our experiences, a double
hepatic artery anastomosis does not increase the risk
of hepatic artery thrombosis and can be performed
safely by surgeons who are experienced with hepatic
vascular reconstructions in a living-donor liver
transplant recipient.
