| The management of an accessory or replaced right hepatic artery during multiorgan retrieval: results of an angiographic study. | |
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MedLine Citation:
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PMID: 20517908 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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In the presence of anatomical variants such as an accessory or replaced (A/R) right hepatic artery (RHA), a conflict of interest can arise during organ retrieval between liver and pancreatic teams. This angiographic study examines the anatomy of the inferior pancreaticoduodenal artery (IPDA), its relation to the A/R RHA, and the implications for the use of livers and pancreases from multiorgan donors. Gastrointestinal angiograms performed in our institution for unrelated indications were reviewed, and the relevant arteries, their diameters, the distances between origins, the time at which variants were found, and the blood supply to relevant solid organs were recorded. A review of 122 angiograms identified 100 patients in whom both the superior mesenteric artery (SMA) and the celiac axis were cannulated synchronously; these patients composed our study cohort. The IPDA was identified in 95% of the cases. There were 8 patients with a replaced RHA and 4 with an accessory RHA. In all 12, the IPDA had an SMA origin; 3 of these shared a common origin with the A/R RHA on the SMA. In the rest, the mean distance between them was 29 mm (range = 17.8-48.3 mm). All anomalous arteries found were segmental vessels. In conclusion, the A/R RHA incidence in our series was 12%, and no case had an IPDA originating from the A/R RHA. Separate accessory RHA and IPDA origins potentially allow an uncompromised accessory RHA (with its Carrel patch) without risk of prejudice to the pancreatic graft if retrieval is accurately performed. Rarely (3%), there is a common origin between the A/R RHA and the IPDA, and back-bench reconstruction would be required to allow the use of both the liver and pancreas. |
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Authors:
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P Thomas Cherian; Bassem Hegab; Simon P Oliff; Stephen J Wigmore |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society Volume: 16 ISSN: 1527-6473 ISO Abbreviation: Liver Transpl. Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-06-02 Completed Date: 2010-09-14 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100909185 Medline TA: Liver Transpl Country: United States |
Other Details:
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Languages: eng Pagination: 742-7 Citation Subset: IM |
Copyright Information:
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(c) 2010 AASLD. |
Affiliation:
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Liver Unit, University Hospital Birmingham, Edgbaston, United Kingdom. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Angiography, Digital Subtraction* Celiac Artery / radiography, surgery Female Hepatic Artery / abnormalities, radiography*, surgery* Humans Liver / blood supply*, surgery* Liver Transplantation Male Mesenteric Artery, Superior / radiography, surgery Middle Aged Pancreas / blood supply*, surgery* Pancreas Transplantation Retrospective Studies Tissue Donors / supply & distribution Tissue and Organ Harvesting* Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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