Hepatic artery occlusion in liver transplantation: What counts more, the type of reconstruction or the severity of the recipient's disease?

Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
Christian E OberkoflerHenrik Petrowsky

Abstract

Although the type of hepatic artery revascularization technique is known to have an impact on patency rates, independent perioperative risk factors on patient outcomes are poorly defined. All consecutive adult patients undergoing cadaveric liver transplantation (n = 361) from July 2007 to June 2016 in a single institution were analyzed. Primary outcomes were early (<30 days) hepatic artery occlusion and primary hepatic artery patency rate. A multivariate model was used to identify independent risk factors for occlusion and the need of arterial conduit, as well as their impact on graft and patient survival. Arterial revascularization without additional reconstruction (end-to-end arterial anastomosis [AA]) was performed in 77% (n = 279), arterial reconstruction (AR) in 15% (n = 53), and aortohepatic conduit (AHC) in 8% (n = 29) of patients. AHC had the highest mean intraoperative flow (275 mL/minute; P = 0.02) compared with AA (250 mL/minute) and AR (200 mL/minute; P = 0.02). There were 43 recipients (12%) who had an occlusive event with successful revascularization in 20 (47%) recipients. One-year primary patency rates of AA, AR, and AHC were 97%, 88%, and 74%, respectively. Aortic calcification had an impact on early occlusion....Continue Reading

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Citations

Jul 12, 2018·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Tim ReeseHenrik Petrowsky
Nov 12, 2018·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·John A GehaJohn A Goss
Dec 26, 2018·Transplant International : Official Journal of the European Society for Organ Transplantation·Rafaela CapelliRené Adam
Oct 13, 2019·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Flavio PaternoJames V Guarrera
Jul 3, 2020·Journal of Thrombosis and Haemostasis : JTH·Yanni LiVincent E de Meijer
Jun 17, 2019·Pediatric Surgery International·Nan MaZhongyang Shen
May 3, 2019·Transplant International : Official Journal of the European Society for Organ Transplantation·Laura LladoJoan Fabregat
Aug 1, 2021·Clinics and Research in Hepatology and Gastroenterology·Jérôme DumortierNathalie Ganne-Carrié

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