AI Article Synopsis
- HA reconstruction is crucial for living donor liver transplantation, and the use of advanced microsurgical techniques has lowered the incidence of HA thrombosis to 2%.
- The study involved 101 HA reconstructions using a specific technique, with surgeries performed by either transplant or plastic surgeons, showing better outcomes with transplant surgeons.
- The findings suggest that unclamping the graft artery during reconstruction is a viable technique that can be effectively performed by trained transplant surgeons.
Article Abstract
Background: Hepatic artery (HA) reconstruction is one of the key steps for living donor liver transplantation (LDLT). The incidence of HA thrombosis has been reduced by the introduction of microsurgical techniques under a high resolution microscope or loupe.
Methods: We report our experience in 101 cases of HA reconstruction in LDLTs using the graft-artery-unclamp and posterior-wall-first technique. The reconstructions were completed by either a plastic surgeon or a transplant surgeon.
Results: The rate of HA thrombosis was 2% (2/101). The risk factors for failed procedures appeared to be reduced by participation of the transplant surgeon compared with the plastic surgeon. For a graft with duplicate arteries, we considered no branches should be discarded even with a positive clamping test.
Conclusions: HA reconstruction without clamping the graft artery is a feasible and simplified technique, which can be mastered by transplant surgeons with considerable microsurgical training.
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