Our experiences on microsurgical anastomosis of hepatic arteries, without thrombosis, in living donor liver transplantations

Abstract

Background/Aims: Liver transplant is the ultimate and exclusive treatment of liver failure. Since the transfer of hepatic lobe takes place along with its own hepatic artery, the anastomosis process requires the utilization of microsurgical techniques and equipment in the living donor liver transplantations (LDLT). The success of the anastomosis directly affects the result of the surgery and thereby effects patient survival. Otherwise, in the case of failure, it can lead to mortality of the patient. The aim of this study is to retrospectively evaluate the hepatic artery anastomosis in terms of vascular characteristics, arterial diameters, operation time, complications, and thrombosis rates and also to achieve more successful results with lower complication rates. Furthermore, the study aims to share the accumulated knowledge and the experience to develop the technique further and to learn how to make the transfer more easily in the future. Materials and Methods: From 2010 to 2017, 85 LDLTs were performed in Ataturk University Organ Transplantation and Research Center. The hepatic artery anastomosis was performed by the same microsurgeon. Results: We have not encountered any hepatic arterial thrombosis. The success of 100% anastomosis in our series is compatible with the literature, and it was found to have a higher success rate. However, the fact that our current series is small should not be overlooked. Conclusion: The collaboration between microsurgeons and transplant surgeons to reduce technical complications can play an important role in obtaining long-term and permanent transplantation outcomes.

Keywords

• anastomosis
• hepatic artery
• living donor liver transplantation
• microsurgery