Volume 14 Issue 1
Jan.  2023
Turn off MathJax
Article Contents
Article Navigation >  ORGAN TRANSPLANTATION  > 2023  >  14(1): 128-134
Li Xincheng, Huang Fan, Wang Guobin, et al. Effect of hepatic artery reconstruction techniques on prognosis of liver transplantation[J]. ORGAN TRANSPLANTATION, 2023, 14(1): 128-134. doi: 10.3969/j.issn.1674-7445.2023.01.017
Citation: Li Xincheng, Huang Fan, Wang Guobin, et al. Effect of hepatic artery reconstruction techniques on prognosis of liver transplantation[J]. ORGAN TRANSPLANTATION, 2023, 14(1): 128-134. doi: 10.3969/j.issn.1674-7445.2023.01.017
shu

Effect of hepatic artery reconstruction techniques on prognosis of liver transplantation

doi: 10.3969/j.issn.1674-7445.2023.01.017

  • Organ Transplantation Center, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China

More Information
  • Corresponding author: Zhao Hongchuan, Email: zhc0117@sina.com
  • Received Date: 2022-08-22
    Available Online: 2023-01-17
  • Publish Date: 2023-01-15
    Abstract
  •   Objective  To evaluate the effect of different techniques of hepatic artery reconstruction on postoperative hepatic artery complications and clinical prognosis in liver transplantation.  Methods  Clinical data of 140 liver transplant recipients were retrospectively analyzed. All recipients were divided into the conventional hepatic artery reconstruction group (n=123) and special hepatic artery reconstruction group (n=17) according to hepatic artery reconstruction methods. Intraoperative and postoperative clinical indexes, the incidence of postoperative hepatic artery complications and survival rate were compared between two groups.  Results  The alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels at postoperative 1 d, total bilirubin (TB) at postoperative 7 d and prothrombin time international normalized ratio (PT-INR) at postoperative 30 d in special hepatic artery reconstruction group were higher than those in conventional hepatic artery reconstruction group, and the differences were statistically significant (all P < 0.05). There were no significant differences in the operation time, anhepatic phase, intraoperative blood loss, intraoperative transfusion volume of red blood cells, cold or warm ischemia time, the length of intensive care unit (ICU) stay, the length of hospital stay and postoperative blood flow of liver allograft between two groups (all P > 0.05). In the conventional hepatic artery reconstruction group, 5 recipients developed hepatic artery complications, whereas no hepatic artery complications occurred in the special hepatic artery reconstruction group, with no significant difference between two groups (P > 0.05). In the special hepatic artery reconstruction group, the 1-, 3- and 5-year cumulative survival rates were equally 82.4%, compared with 85.0%, 78.9% and 75.6% in the conventional hepatic artery reconstruction group, respectively. There was no significant difference between two groups (all P > 0.05).  Conclusions  When hepatic artery variations and (or) lesions are detected in donors and recipients, use of special hepatic artery reconstruction may effectively restore the hepatic arterial blood flow of liver allograft after liver transplantation, and will not affect the incidence of hepatic artery complications and survival rate of the recipients following liver transplantation.

     

    • FullText(HTML)
  • loading
    • References(30)
  • [1]
    AKBULUT S, KUTLUTURK K, YILMAZ S. Hepatic artery reconstruction technique in liver transplantation: experience with 3, 000 cases[J]. Hepatobiliary Surg Nutr, 2021, 10(2): 281-283. DOI: 10.21037/hbsn-21-2.
    [2]
    NG SW. Hepatic artery anastomosis in liver transplantation[J]. Ann Acad Med Singap, 2021, 50(9): 666-668. DOI: 10.47102/annals-acadmedsg.2021332.
    [3]
    BEAUREPAIRE JM, ORLANDO F, LEVI SANDRI GB, et al. Comparison of alternative arterial anastomosis site during liver transplantation when the recipient's hepatic artery is unusable[J]. Hepatobiliary Surg Nutr, 2022, 11(1): 1-12. DOI: 10.21037/hbsn-20-10.
    [4]
    TAN BK, FONG HC, TAN EK, et al. Strategies for a successful hepatic artery anastomosis in liver transplantation: a review of 51 cases[J]. Ann Acad Med Singap, 2021, 50(9): 679-685. DOI: 10.47102/annals-acadmedsg.2020635.
    [5]
    何博, 王新, 王峰, 等. 肝移植供肝动脉变异与重建方式对术后早期动脉并发症的影响[J]. 临床肝胆病杂志, 2021, 37(8): 1901-1904. DOI: 10.3969/j.issn.1001-5256.2021.08.030.

    HE B, WANG X, WANG F, et al. Influence of arterial variation and reconstruction of the donor hepatic artery in liver transplantation on early postop-erative arterial complications[J]. J Clin Hepatol, 2021, 37(8): 1901-1904. DOI: 10.3969/j.issn.1001-5256.2021.08.030.
    [6]
    LIN TS, LIN CH, KUO PJ, et al. Management of difficult hepatic artery reconstructions to reduce complications through continual technical refinements in living donor liver transplantations[J]. Int J Surg, 2022, 104: 106776. DOI: 10.1016/j.ijsu.2022.106776.
    [7]
    曹阳, 张洪涛, 彭伟, 等. 公民逝世后器官捐献肝移植发生肝动脉并发症的影响因素分析[J]. 中华消化外科杂志, 2021, 20(10): 1055-1060. DOI: 10.3760/cma.j.cn115610-20210901-00429.

    CAO Y, ZHANG HT, PENG W, et al. Analysis of influencing factors for hepatic artery complications of liver transplantation from donation after citizen's death[J]. Chin J Dig Surg, 2021, 20(10): 1055-1060. DOI: 10.3760/cma.j.cn115610-20210901-00429.
    [8]
    LI PC, THORAT A, JENG LB, et al. Hepatic artery reconstruction in living donor liver transplantation using surgical loupes: achieving low rate of hepatic arterial thrombosis in 741 consecutive recipients-tips and tricks to overcome the poor hepatic arterial flow[J]. Liver Transpl, 2017, 23(7): 887-898. DOI: 10.1002/lt.24775.
    [9]
    KARAKOYUN R, ROMANO A, YAO M, et al. Impact of hepatic artery variations and reconstructions on the outcome of orthotopic liver transplantation[J]. World J Surg, 2020, 44(6): 1954-1965. DOI: 10.1007/s00268-020-05406-4.
    [10]
    CIROCCHI R, D'ANDREA V, LAURO A, et al. The absence of the common hepatic artery and its implications for surgical practice: results of a systematic review and meta-analysis[J]. Surgeon, 2019, 17(3): 172-185. DOI: 10.1016/j.surge.2019.03.001.
    [11]
    郭亚飞, 刘国岩, 朱泽斌, 等. 解剖性肝动脉重建在肝移植中的应用价值[J/CD]. 中华肝脏外科手术学电子杂志, 2021, 10(4): 376-380. DOI: 10.3877/cma.j.issn.2095-3232.2021.04.008.

    GUO YF, LIU GY, ZHU ZB, et al. Application value of anatomical hepatic artery reconstruction in liver transplantation[J/CD]. Chin J Hepatic Surg (Electr Edit), 2021, 10(4): 376-380. DOI: 10.3877/cma.j.issn.2095-3232.2021.04.008.
    [12]
    HIATT JR, GABBAY J, BUSUTTIL RW. Surgical anatomy of the hepatic arteries in 1000 cases[J]. Ann Surg, 1994, 220(1): 50-52. DOI: 10.1097/00000658-199407000-00008.
    [13]
    GEHA JA, GEHA JD, O'MAHONY CA, et al. Recons-truction of the replaced right hepatic artery using donor iliac arterial Y-graft in orthotopic liver transplantation[J]. Liver Transpl, 2019, 25(1): 167-170. DOI: 10.1002/lt.25380.
    [14]
    JIANG WT, YANG J, XIE Y, et al. Simultaneous partial splenectomy during liver transplantation for advanced cirrhosis patients combined with severe splenomegaly and hypersplenism[J]. World J Gastroenterol, 2021, 27(7): 654-665. DOI: 10.3748/wjg.v27.i7.654.
    [15]
    KIM EN, LAMB K, RELLES D, et al. Median arcuate ligament syndrome-review of this rare disease[J]. JAMA Surg, 2016, 151(5): 471-477. DOI: 10.1001/jamasurg.2016.0002.
    [16]
    NAKADA S, ALLARD MA, LEWIN M, et al. Ischemic cholangiopathy following transcatheter arterial chemoembolization for recurrent hepatocellular carcinoma after hepatectomy: an underestimated and devastating complication[J]. J Gastrointest Surg, 2020, 24(11): 2517-2525. DOI: 10.1007/s11605-019-04409-4.
    [17]
    TSURUSAKI M, MURAKAMI T. Surgical and locoregional therapy of HCC: TACE[J]. Liver Cancer, 2015, 4(3): 165-175. DOI: 10.1159/000367739.
    [18]
    PANARO F, RAMOS J, GALLIX B, et al. Hepatic artery complications following liver transplantation. does preoperative chemoembolization impact the postoperative course?[J]. Clin Transplant, 2014, 28(5): 598-605. DOI: 10.1111/ctr.12358.
    [19]
    王光辉. 肝移植受体合并正中弓状韧带综合征时的动脉重建研究(附6例报告)[D]. 吉林: 吉林大学, 2020.
    [20]
    HORTON KM, TALAMINI MA, FISHMAN EK. Median arcuate ligament syndrome: evaluation with CT angiography[J]. Radiographics, 2005, 25(5): 1177-1182. DOI: 10.1148/rg.255055001.
    [21]
    SNEIDERS D, HOUWEN T, PENGEL LHM, et al. Systematic review and meta-analysis of posttransplant hepatic artery and biliary complications in patients treated with transarterial chemoembolization before liver transplantation[J]. Transplantation, 2018, 102(1): 88-96. DOI: 10.1097/TP.0000000000001936.
    [22]
    GOSS MB, GALVÁN NTN, GEHA JD, et al. Splenic artery transposition for liver transplantation: an underutilized technique?[J]. Transplant Direct, 2021, 7(2): e661. DOI: 10.1097/TXD.0000000000001103.
    [23]
    LLADO L, RAMOS E, BRAVO A, et al. Short- and long-term outcomes of arterial reconstruction on recipient splenic artery in adult liver transplantation. single-center prospective study 25 years after first description[J]. Transpl Int, 2019, 32(10): 1053-1060. DOI: 10.1111/tri.13447.
    [24]
    KAZEMI K, SAMIDOOST P, DEILAMI HN, et al. A new consideration in hepatic artery reconstruction in adult liver transplant: arterial transposition versus extra-anatomic jump grafts[J]. Exp Clin Transplant, 2017, 15(Suppl 1): 204-207. DOI: 10.6002/ect.mesot2016.P82.
    [25]
    李晓航, 张佳林, 吴刚, 等. 应用供者髂动脉行腹主动脉搭桥重建移植肝动脉的临床分析[J/CD]. 中华移植杂志(电子版), 2019, 13(3): 215-218. DOI: 10.3877/cma.j.issn.1674-3903.2019.03.011.

    LI XH, ZHANG JL, WU G, et al. Hepatic artery reconstruction using donor's iliac artery through abdominal aorta bypass graft in orthotopic liver transplantation[J/CD]. Chin J Transplant (Electr Edit), 2019, 13(3): 215-218. DOI: 10.3877/cma.j.issn.1674-3903.2019.03.011.
    [26]
    HIBI T, NISHIDA S, LEVI DM, et al. Long-term deleterious effects of aortohepatic conduits in primary liver transplantation: proceed with caution[J]. Liver Transpl, 2013, 19(8): 916-925. DOI: 10.1002/lt.23689.
    [27]
    FANG J, CHEN Z, JIANG N, et al. Reconstruction of the hepatic artery using the superior mesenteric artery for liver transplantation[J]. Ann Transl Med, 2020, 8(22): 1520. DOI: 10.21037/atm-20-7200.
    [28]
    张春, 刘司南, 师建华, 等. 成人原位肝移植后肝动脉血栓的诊断与治疗[J]. 中华消化外科杂志, 2021, 20(10): 1061-1067. DOI: 10.3760/cma.j.cn115610-20210913-00456.

    ZHANG C, LIU SN, SHI JH, et al. Diagnosis and treatment of hepatic artery thrombosis after adult orthotopic liver transplantation[J]. Chin J Dig Surg, 2021, 20(10): 1061-1067. DOI: 10.3760/cma.j.cn115610-20210913-00456.
    [29]
    CRAIG EV, HELLER MT. Complications of liver transplant[J]. Abdom Radiol (NY), 2021, 46(1): 43-67. DOI: 10.1007/s00261-019-02340-5.
    [30]
    中华医学会器官移植学分会围手术期管理学组. 肝移植围手术期血管并发症诊治专家共识(2021版)[J]. 临床肝胆病杂志, 2021, 37(9): 2054-2057. DOI: 10.3969/j.issn.1001-5256.2021.09.010.

    Perioperative Management Group of Branch of Organ Transplantation of Chinese Medical Association. Expert consensus on perioperative vascular complications for liver transplantation (2021)[J]. J Clin Hepatol, 2021, 37(9): 2054-2057. DOI: 10.3969/j.issn.1001-5256.2021.09.010.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(3)  / Tables(4)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (207) PDF downloads(73) Cited by()
    Proportional views
    Related

    WeChat Subscription Account

    Wechat Service Account

    Contact Us
    • Tel：020-38736410
    • Email: organtranspl@163.com
    • Address：The Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Road, Tianhe District, Guangzhou
    • Editorial Office of Organ Transplantation  粤ICP备2021030844号
    Links

    Supported by: Beijing Renhe Information Technology Co. Ltd    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return