1 Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 2 Address correspondence to: Hideaki Uchiyama, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu, University, Fukuoka, 812-8582, Japan.
Transplantation. 2014 Jun 15;97(11):1172-7. doi: 10.1097/01.TP.0000442687.33536.c4.
Hepatic grafts used in living donor liver transplantation (LDLT) sometimes have two or more arteries, in which surgeons are required to perform complex arterial reconstruction. The aim of the current study was to demonstrate whether selecting living donor liver grafts with double or triple arteries yielded the same outcomes as grafts with a single artery.
We retrospectively investigated the outcomes of LDLT focusing on the numbers of arteries on grafts. Four hundred forty-six cases of LDLT performed between October 1996 and October 2012 were retrospectively analyzed. The cases were divided into the following three groups according to the number of arteries on a graft: the single (n=331), the double (n=108), and the triple (n=7) groups.
Artery-related complications occurred in five cases in the single group, two cases in the double group, and no case in the triple group. Although the overall graft survival was comparable among the three groups, there was a tendency of worsened graft survival and increased incidence of anastomotic biliary stricture after liver transplantation in right hepatic grafts with double arteries.
The use of grafts with double or triple arteries yielded favorable outcomes with minimum artery-related complications compared with grafts with a single artery. However, the use of right hepatic grafts with double arteries is discouraging in the current study.
在活体肝移植（LDLT）中使用的肝移植物有时有两条或更多的动脉，这就要求外科医生进行复杂的动脉重建。本研究的目的是证明选择具有双或三动脉的活体供肝移植物与具有单动脉的移植物的结果是否相同。
我们回顾性地研究了 LDLT 的结果，重点关注移植物上的动脉数量。回顾性分析了 1996 年 10 月至 2012 年 10 月期间进行的 446 例 LDLT。根据移植物上的动脉数量将病例分为以下三组：单动脉组（n=331）、双动脉组（n=108）和三动脉组（n=7）。
单动脉组有 5 例发生与动脉相关的并发症，双动脉组有 2 例，三动脉组无病例。尽管三组总体移植物存活率相当，但右肝移植物双动脉组的移植物存活率下降趋势和吻合口胆管狭窄发生率增加。
与单动脉移植物相比，使用双或三动脉移植物可获得良好的结果，并且动脉相关并发症最少。然而，在本研究中，使用双动脉的右肝移植物是令人沮丧的。
