Comparison of alternative arterial anastomosis site during liver transplantation when the recipient’s hepatic artery is unusable - Université de Rennes Accéder directement au contenu
Article Dans Une Revue Hepatobiliary Surgery and Nutrition Année : 2022

Comparison of alternative arterial anastomosis site during liver transplantation when the recipient’s hepatic artery is unusable

Résumé

BACKGROUND: Few studies have analyzed outcomes of liver transplantation (LT) when the recipient hepatic artery (HA) was not usable. METHODS: We retrospectively evaluated the outcomes of LT performed using the different alternative sites to HA. RESULTS: Between 2002 and 2017, 1,677 LT were performed in our institution among which 141 (8.4%) with unusable recipient HA were analyzed. Four groups were defined according to the site of anastomosis: the splenic artery (SA group, n=26), coeliac trunk (CT group, n=12), aorta using or not the donor’s vessel (Ao group, n=91) and aorta using a vascular prosthesis (Ao-P group, n=12) as conduit. The median number of intraoperative red blood cell transfusions was significantly increased in the Ao and Ao-P groups (5, 5, 8.5 and 16 for SA, CT, Ao and Ao-P group respectively, P=0.002), as well as fresh frozen plasma (4.5, 2.5, 10, 17 for the SA, CT, Ao and Ao-P groups respectively, P=0.001). Hospitalization duration was also significantly increased in the Ao and Ao-P groups (15, 16, 24, 26.5 days for the SA, CT, Ao and Ao-P groups respectively, P<0.001). The occurrence of early allograft dysfunction (EAD) (P=0.07) or arterial complications (P=0.26) was not statistically different. Level of factor V, INR, bilirubin and creatinine during the 7(th) postoperative days (POD) was significantly improved in the SA group. No difference was observed regarding graft (P=0.18) and patient (P=0.16) survival. CONCLUSIONS: In case of unusable HA, intraoperative and postoperative outcomes are improved when using the SA or CT compared to aorta.
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hal-03631374 , version 1 (30-05-2022)

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Paternité - Pas d'utilisation commerciale - Pas de modification

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Jean Marie Beaurepaire, Francesco Orlando, Giovanni Battista Levi Sandri, Caroline Jezequel, Edouard Bardou-Jacquet, et al.. Comparison of alternative arterial anastomosis site during liver transplantation when the recipient’s hepatic artery is unusable. Hepatobiliary Surgery and Nutrition, 2022, 11 (1), pp.1-12. ⟨10.21037/hbsn-20-10⟩. ⟨hal-03631374⟩
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