Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Liver Transplant Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Pediatr Surg Int. 2022 Nov 28;39(1):13. doi: 10.1007/s00383-022-05281-1.
To present our experience of using the pediatric donor superior mesenteric artery (SMA) as the interpositioning vessel to reconstruct the hepatic artery in pediatric deceased donor liver transplantation.
Pediatric patients who received pediatric deceased donor livers from December 2019 to June 2021 were enrolled.
A total of 43 pediatric recipients received pediatric deceased donor livers during the study period. Thirty-four (79.1%) pediatric donors had normal hepatic artery anatomy, while nine (20.9%) showed variant anatomies. The SMAs of the pediatric donors were interposed in the latter eight cases. The anastomosis between the donor distal SMA and the donor celiac trunk artery (CTA) was initially performed in the back-table period, after which the other anastomosis between the donor proximal SMA and recipient CHA was performed. Only one case showed HAT occurrence (incidence rate, 2.3%). However, no arterial complications occurred in pediatric recipients with donor grafts that showed the variation of RHA replacement from the SMA and had undergone usage of the donor's SMA as an interpositioning vessel.
In pediatric deceased donor liver transplantation, the use of SMA as an interpositioning medium can solve the problems related to a tiny caliber and anatomical variations of the donor hepatic artery.
介绍我们在小儿尸体肝移植中使用小儿供体肠系膜上动脉（SMA）作为桥血管重建肝动脉的经验。
纳入 2019 年 12 月至 2021 年 6 月期间接受小儿尸体供肝的患儿。
研究期间，共有 43 名小儿受体接受了小儿尸体供肝。34 例（79.1%）小儿供体肝动脉解剖正常，9 例（20.9%）显示变异解剖。后 8 例将 SMA 作为桥血管进行重建。供体远端 SMA 与供体腹腔干动脉（CTA）的吻合在离体期间完成，然后进行供体近端 SMA 与受体 CHA 的另一次吻合。仅 1 例发生 HAT（发生率 2.3%）。然而，对于因 RHA 由 SMA 替代而出现变异且使用供体 SMA 作为桥血管的供体肝移植患儿，未发生动脉并发症。
在小儿尸体肝移植中，使用 SMA 作为桥接介质可以解决供体肝动脉口径小和解剖变异的问题。
