Document Detail


Use of an aberrant right hepatic artery arising from the superior mesenteric artery of the recipient for arterial reconstruction in liver transplantation.
MedLine Citation:
PMID:  21183875     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Our aim was to report a single centre experience of using a recipient's aberrant right hepatic artery (RHA) from the superior mesenteric artery (SMA) to establish inflow into liver allografts.
MATERIAL/METHODS: All patients who had arterial reconstruction with an aberrant RHA were identified from a prospective database (1989-2004). Indications and outcomes were evaluated, with particular reference to arterial complications.
RESULTS: An aberrant RHA was used in 27/2518 recipients (1%), including 6 paediatric recipients. Indications were replaced CHA (4), hypoplastic CHA (7), atheroma (12), previous conduit (1) and poor post-anastomotic flow (3). After a median of 42 months, arterial complications occurred in 2 paediatric recipients (hepatic artery thrombosis 1; arterial stenosis 1). Four patients developed anastomotic biliary strictures, and one paediatric recipient developed ischaemic cholangiopathy after hepatic artery thrombosis. Two patients underwent retransplantation (one patient with arterial stenosis). 1-year and 5-year patient survival rates were 85% and 81%. There were 6 deaths unrelated to vascular complications.
CONCLUSIONS: In adult liver transplant recipients with an unsuitable common hepatic artery, an aberrant right hepatic artery may be used to establish arterial inflow. This technique may be associated with a higher rate of vascular complications in paediatric recipients, and should be used cautiously in this group.
Authors:
Robert P Sutcliffe; Evangelos Lolis; Andreas A Prachalias; Parthi Srinivasan; Mohamed Rela; Mohamed Rela; Nigel D Heaton
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of transplantation : quarterly of the Polish Transplantation Society     Volume:  15     ISSN:  2329-0358     ISO Abbreviation:  Ann. Transplant.     Publication Date:    2010 Oct-Dec
Date Detail:
Created Date:  2010-12-24     Completed Date:  2011-04-19     Revised Date:  2013-06-17    
Medline Journal Info:
Nlm Unique ID:  9802544     Medline TA:  Ann Transplant     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  44-8     Citation Subset:  IM    
Affiliation:
Department of Surgery, Royal London Hospital, Whitechapel Road, London, U.K.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Child
Child, Preschool
Female
Graft Survival
Hepatic Artery / abnormalities,  surgery*
Humans
Infant
Liver Transplantation / methods*
Male
Mesenteric Artery, Superior / surgery*
Middle Aged
Postoperative Complications
Prospective Studies
Treatment Outcome
Young Adult

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


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