Low incidence of hepatic artery thrombosis after hepatic artery reconstruction in liver transplanation
O Kornasiewicz, Z Lewandowski, M Grąt, A Ścibisz, M Krawczyk
Ann Transplant 2009; 14(1): 43-43
Available online: 2009-05-21
Background: Hepatic artery thrombosis (HAT) remains an important cause
of graft loss after liver transplantation. HAT can be caused by technical, hemodynamic, or immunological factors. Bench reconstruction of anatomical variants of the hepatic artery is considered to be a major risk related to HAT. The purposes of the study were to analyse the inï¬‚ uence of vascular reconstruction of the hepatic artery and its relation to HAT.
Material/Methods: We analysed, in retrospective study, 341 donors' forms
completed between January 2003 and December 2007. Vascular reconstruction was defined as an additional anastomosis between the donor's hepatic arteries which was required to obtain a full revascularisation of the graft. Any incident of HAT was confi rmed by angiography or intraoperatively during re-transplanation. The Fishers Exact Test and 95% confidence intervals (CI) estimator were applied for statistical analysis.
Results: Of 341 grafts, hepatic artery anomalies were found in 92 cases
(26.9%). In 33 (35.8%) cases hepatic artery reconstruction was required. The HAT was diagnosed in 3% (1 of 33) with hepatic reconstruction group (CI 0.1%-15.8%) compared with 1.6% of grafts (5 of 208) which did not require hepatic reconstruction (p<0.45). There was one case of hepatic thrombosis (1 of 59) totalling 1.6% in the group with hepatic anomalies without reconstruction (CI 0.04-9.1%)
Conclusions: A single hepatic reconstruction is a non significant factor for HAT. The hepatic artery anomalies do not increase the risk of HAT compared with the normal blood supply. The hepatic artery anomalies do not increase significantly the incidence of HAT compared to group of patient without anatomical abnormalities.
Keywords: Liver Transplantation