Frequency of Anatomic Variations on Hepatic Arteries and Types of Reconstruction Employed: Study on Livers Prepared for Transplantation.

BACKGROUND

Recognition of anatomic variations in the hepatic artery is important at the time of organ uptake and at the back table for transplantation.

PURPOSE

To know the frequency of these variations, in a 5-year series of liver transplantation and the various types of arterial reconstruction used in back table surgery.

METHODS

We analyzed 340 donor files and calculated the frequencies of the various anatomic variations of the hepatic artery, according to Hiatt, and the types of vascular reconstruction employed.

RESULTS

In total, 225 cases (66.17%) had a single hepatic artery, considered unchanged (type I), originating from the celiac trunk. Forty-six (13.52%) and 44 (12.94%) were, respectively, type II and III. Eight cases (2.35%) had a type II and III association (type IV), and another 8 (2.35%) were type V. There were no type VI cases. Nine cases were not described in the Hiatt classification. The most common reconstruction was right hepatic and splenic artery anastomosis, performed in 53 cases (91.37%). In 4 cases, this reconstruction was performed with the gastroduodenal (6.89%). In 1 case of 3 arteries with independent origins, in the aorta, reconstruction was performed using the iliac artery graft (common and its bifurcation), taken from the organ donor (1.72%).

CONCLUSIONS

The most common variations were the presence of a left or right hepatic artery alone, each with a frequency of 13%, and the most commonly used reconstruction was the right hepatic with splenic arteries anastomosis.