Use of arterial conduit for arterial revascularization during liver and multivisceral transplantation  

作　　者：MA Yi LI Qiang YE Zhi-ming ZHU Xiao-feng HE Xiao-shun 

机构地区：[1]Organ Transplantation Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China

出　　处：《Chinese Medical Journal》2011年第19期2986-2989,共4页中华医学杂志（英文版）

基　　金：This study was supported by a grant from the Guangdong Natural Science Foundation （No. 9151008901000052）.

摘　　要：Background At present, revascularization is still one of the most critical technologies in orthotopic liver transplantation （OLT）. Hepatic artery （HA） variations occur frequently in both donors and recipients. Moreover, there are always some pathological changes in the recipient hepatic artery. If handled improperly, it may cause complications after anastomosis.Therefore, arterial conduit could be used in primary OLT, re-OLT and multiple-OLT. This study aimed to investigate the indications, methods and techniques with usage of arterial conduit for HA revascularization during adult OLT.Methods We reviewed 1200 patients of consecutive OLTs performed during 2000-2009 in the First Affiliated Hospital of Sun Yat-sen University. Of these patients, 48 recipients with artery variations received HA revascularization with usage of arterial conduit and special postoperative managements. The indications, methods, techniques, and the managements of postoperative complications in adult OLT with usage of arterial conduit for HA revascularization were analyzed.Results In 48 cases with artery bypass, the arterial conduit were anastomosed between donor hepatic artery and recipient infrarenal aorta （n=32）, between donor hepatic artery and recipient suprarenal aorta （n=10）, and between donor upper abdominal organ cluster artery and recipient suprarenal aorta （n=6）. The technique was applied in 4% （48/1200 cases） of the whole OLTs performed in the same period, and the patency rate of the conduits was 100%. Forty patients （83.3%） survived, and the average survival time was 3.9 years. Eight patients （16.7%） died （all due to tumor recurrence）,while the average survival time was 1.2 years. All these patients have not experienced artery-related complications in their survival time.Conclusions When recipient HA has variations or pathological changes in OLT, the donor artery should be anastomosed to recipient abdominal aorta with an arterial conduit to achieve satisfactory outcomes. For arterial anastomosBackground At present, revascularization is still one of the most critical technologies in orthotopic liver transplantation （OLT）. Hepatic artery （HA） variations occur frequently in both donors and recipients. Moreover, there are always some pathological changes in the recipient hepatic artery. If handled improperly, it may cause complications after anastomosis.Therefore, arterial conduit could be used in primary OLT, re-OLT and multiple-OLT. This study aimed to investigate the indications, methods and techniques with usage of arterial conduit for HA revascularization during adult OLT.Methods We reviewed 1200 patients of consecutive OLTs performed during 2000-2009 in the First Affiliated Hospital of Sun Yat-sen University. Of these patients, 48 recipients with artery variations received HA revascularization with usage of arterial conduit and special postoperative managements. The indications, methods, techniques, and the managements of postoperative complications in adult OLT with usage of arterial conduit for HA revascularization were analyzed.Results In 48 cases with artery bypass, the arterial conduit were anastomosed between donor hepatic artery and recipient infrarenal aorta （n=32）, between donor hepatic artery and recipient suprarenal aorta （n=10）, and between donor upper abdominal organ cluster artery and recipient suprarenal aorta （n=6）. The technique was applied in 4% （48/1200 cases） of the whole OLTs performed in the same period, and the patency rate of the conduits was 100%. Forty patients （83.3%） survived, and the average survival time was 3.9 years. Eight patients （16.7%） died （all due to tumor recurrence）,while the average survival time was 1.2 years. All these patients have not experienced artery-related complications in their survival time.Conclusions When recipient HA has variations or pathological changes in OLT, the donor artery should be anastomosed to recipient abdominal aorta with an arterial conduit to achieve satisfactory outcomes. For arterial anastomos

关 键 词：liver transplantation hepatic artery iliac artery graft 

分 类 号：Q959.223[生物学—动物学] Q813