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| Hepatic arterial anastomosis in adult liver transplantation |
| Kai-Wun Chang a , # , Zhe Yang b , # , Shuo Wang a , b , # , Shu-Sen Zheng a , b , c , d , ∗ |
a Zhejiang University School of Medicine, Hangzhou 310000, China
b Department of Hepatobiliary and Pancreatic Surgery, Department of Liver Transplantation, Shulan (Hangzhou) Hospital, Zhejiang Shuren University School of Medicine, Hangzhou 310022, China
c Division of Hepatobiliary Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
d National Clinical Research Center of Infectious Diseases, Hangzhou 310003, China
∗ Corresponding author at: Zhejiang University School of Medicine, Hangzhou 310000, China.
E-mail address: shusenzheng@zju.edu.cn (S.-S. Zheng).
# Contributed equally. |
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Abstract Hepatic arterial reconstruction remains a critically challenging technique in liver transplantation, as efficient graft and patient survival are dependent on strong and continuous arterial blood supply to the donor liver [1,2]. Complex arterial reconstruction has been identified as a crucial risk factor for arterial thrombosis [1–5]. Consequently, selecting the appropriate arterial reconstruction method to decrease hepatic artery thrombosis has garnered the attention of the surgical community. The first case of a standard surgical technique employed in a patient with hepatic malignancy was reported in 1969 [6] . Arterial reconstruction was performed through anastomosis of the donor’s celiac trunk to the recipient’s common hepatic artery. Over the past decade, significant advancements have been made in the field of hepatic arterial reconstruction. Several studies have reported favorable outcomes with aortohepatic anastomosis, with or without conduits [7–9] , celiac trunk [10,11] or splenic artery [1,4,12] in liver recipients with unusable hepatic arteries due to complete thrombosis, intimal dissection, small size, or inadequate blood flow. Regarding the choice of arterial anastomosis sites, the surgeons either decide intraoperatively after evaluating the quality and blood flow of the recipient hepatic artery or make the decision preoperatively in case of known thrombosis. The surgeon also selects an alternative arterial site based on the surgeon’s judgment [10] .
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2023, Vol. 22 
