Hepatic artery reconstruction in living donor liver transplant experience at King Hussein Medical Center

Abstract EN

Objective : Living donor liver transplantation is being increasingly carried out successfully in adults and children in many centers around the world.

This multi tasked surgery is carried out by several teams of surgeons.

The aim of this study is to present the results of hepatic artery reconstruction carried out by the Plastic and Reconstructive surgeons in the liver transplant surgery team at King Hussein Medical Center (KHMC).

Methods : From June 2004 to October 2012 seventy five living donor liver transplant surgeries were carried out at KHMC for seventy four patients (one redo).

There were 56 males and 18 females, with a mean age of 42 years (age range, 2-62 years).

The mean body weight of these patients was 67.03 kg (range, 13-100 kg).

The hepatic artery in all patients was reconstructed using a classical end to end anastomosis using an 8 / 0 or 9 / 0 nylon suture under microscopic magnification by the same team of microsurgeons.

We present our experience and show complications related to hepatic artery reconstruction.

Results : The mean diameter of the graft’s hepatic artery was 1.8 mm (Range 1.1-2.4 mm), and the mean diameter of the recipient artery was 2.3 mm (Range 1.3-3.2 mm).

Three of the recipients (4 %) experienced early hepatic arterial thrombosis (HAT).

In 16 occasions (21 %) we had to redo the anastomosis of the hepatic artery due to inadequate flow.

Conclusion : There is a learning curve during the progress of our program in living donor liver ransplants (LDLT).

The results have significantly improved with better selection of the recipients, echnical refinements, and improvement in perioperative care.