A Long Graft Artery is a Safe and Reproducible Procedure for Arterial Reconstruction In Liver Transplantation.

BACKGROUND

Although a short and nonredundant anastomosis is most often performed in liver transplantation, there is no strong evidence in the literature about the ideal arterial reconstruction. We describe here the "long-artery" technique that enables a wide side-to-end anastomosis and preserves arterial length.

METHODS

We present the results between 2011 and 2019 of the "long-artery" technique performed in our center. Patients with a split liver transplantation or aortohepatic conduits were not included. This technique uses the whole arterial axis of the graft. A side-to-end anastomosis is performed between the common and/or proper hepatic artery of the recipient, and the celiac trunk with an aortic patch of the graft, while the gastroduodenal artery of the recipient is preserved. An omental flap is positioned under the graft artery to prevent kinking.

RESULTS

Eight hundred thirty-two transplant patients were included in the analysis. Early hepatic artery thrombosis was diagnosed in 22 (2.6%) patients and occurred within the first 10 days after the procedure. A thrombectomy was performed in 7 patients, which was successful in 4 patients, and 18 patients were retransplanted. Seven patients (0.8%) developed a late hepatic artery thrombosis, including 2 patients who were retransplanted.

CONCLUSIONS

The "long-artery" technique is a safe and efficient technique for arterial reconstruction in liver transplantation and does not seem to increase the rate of early hepatic artery thrombosis.