Document Detail


Arterial reconstruction in a case of subintimal dissection of celiac arterial tributaries in living donor liver transplantation: a case report.
MedLine Citation:
PMID:  19100493     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hepatic arterial reconstruction is one of the critical issues in living donor liver transplantation (LDLT). Herein we have reported an LDLT case whose celiac arterial trunk tributaries were insufficient as host arteries because of extensive subintimal dissection proceeding to all tributaries of the celiac arterial trunk. PATIENTS AND METHODS: A 45-year-old woman with fulminant hepatic failure underwent LDLT. After reperfusion of the hepatic and portal veins, subintimal dissection of the recipient right and left hepatic arteries was found to extend to all tributaries of the celiac arterial trunk, preventing an anastomosis using the more proximal part of these arteries. Therefore, a jejunal arterial arcade of Roux-en-Y limb mobilized for biliary reconstruction was anastomosed to the donor left hepatic artery in end-to-end fashion. RESULTS: Arterial blood flow to the grafted liver was established successfully, and the patient's postoperative recovery was excellent. Postoperative computed tomography demonstrated sufficient hepatic arterial blood flow. The patient is doing well 4 years after transplantation. CONCLUSION: The method of hepatic graft arterialization described herein is an important option for LDLT recipients when tributaries of the celiac arterial trunk are insufficient as host arteries.
Authors:
T Ikegami; Y Masuda; Y Ohno; K Urata; Y Nakazawa; S Miwa; Y Hashikura; S Miyagawa
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Transplantation proceedings     Volume:  40     ISSN:  0041-1345     ISO Abbreviation:  Transplant. Proc.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-22     Completed Date:  2009-02-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0243532     Medline TA:  Transplant Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3794-6     Citation Subset:  IM    
Affiliation:
Department of Surgery, Shinshu University, School of Medicine, Matsumoto, Nagano, Japan. tikegami@hsp.md.shinshu-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aneurysm, Dissecting / surgery*
Arterioles / surgery
Blood Flow Velocity
Celiac Artery / surgery*
Female
Hepatic Artery / surgery*
Humans
Liver Failure, Acute / surgery*
Liver Transplantation / adverse effects*,  methods
Living Donors
Middle Aged
Reconstructive Surgical Procedures
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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