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| New variation of median arcuate ligament compression causing hepatic arterial hypoperfusion during liver transplantation |
| Noel Cassar ∗, Stephen Gregory , Krishna Menon |
Institute of Liver Studies, King’s Healthcare Partners, Denmark Hill Site, London SE5 9RS, UK
∗ Corresponding author.
E-mail address: noel_mt@yahoo.com (N. Cassar). |
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Abstract Satisfactory blood flow after hepatic arterial anastomosis in liver transplantation is a critical point of the operation. Problems with this anastomosis can result in hepatic artery thrombosis with resultant graft failure and patient morbidity and mortality. Causes of hepatic artery thrombosis include problematic technique, hepatic artery dissection, external compression (e.g. from hematoma), hypercoagulable state, splenic arterial steal and rarer causes such as median arcuate ligament compression (MALC). A careful review of preoperative radiology and imaging will reveal these rare instances and enable a proper intraoperative plan.
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2020, Vol. 19 
