Hepatic artery kinking during liver transplantation: survey and prospective intraoperative flow measurement.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
Fabrizio PanaroFrancis Navarro

Abstract

Hepatic artery thrombosis (HAT) represents the most common vascular complication occurring after liver transplantation (LT). Herein, we report the results of a prospective study of hepatic artery flow (HAF) measurement during abdominal wall closure after LT along with the results of an international survey of procedures adopted, in order to avoid the arterial kinking (AK) in case of long artery. Sixty-four surgeons were asked regarding the different procedures used to avoid AK in the presence of long artery. We prospectively assessed the HAF during three phases of LT in 26 consecutive LT performed in patients with a long HA: after completion of the biliary anastomosis (M0), and partial abdominal wall closure with (M1w) or without (M1w/o) hepatic artery anti-kinking method (HAAK). Sixty (93.7 %) surgeons replied to the survey: 44 (73.3 %) surgeons cut the artery as short as possible, of whom 38 (86.3 %) interposed an oxidized polymer or the omentum, and six (13.7 %) used other systems. Fourteen (23.3 %) surgeons did not use any interposition methods. The remaining two (3.3 %) surgeons left a long artery without HAAK. In our cohort we obtained the following HAF measures: M0 152 mL/min (89-205), M1 without HAAK 114 (66-168) and M1...Continue Reading

References

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Jul 12, 2011·Transplant International : Official Journal of the European Society for Organ Transplantation·Fabrizio PanaroFrancis Navarro

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Citations

Feb 2, 2013·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Fabrizio PanaroFrancis Navarro
Feb 26, 2014·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Fabrizio PanaroFrancis Navarro
Mar 26, 2013·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Yu-Shu ChengYao-Li Chen
Dec 7, 2017·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Roberto MontaltiMarco Vivarelli

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