Hepatic arterial anatomy for right liver procurement from living donors

✍ Scribed by Henkie P. Tan; Amadeo Marcos

• Book ID: 102465924
• Publisher: John Wiley and Sons
• Year: 2004
• Tongue: English
• Weight: 45 KB
• Volume: 10
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.20028

✦ Synopsis

are to be congratulated for their large numbers of living donor liver transplants (from January 1996 to May 2003, 72 out of 233 patients had right-lobe living donor liver transplants [RLDLT]). They reported a 6% incidence of hepatic arterial bifurcations that might provide multiple orifices in right liver grafts by preoperative angiography, but only one right liver graft (1%) determined operatively had multiple arterial orifices. They concluded that their report conflicted with our experience, because in their series, no patients underwent double hepatic artery reconstruction in right-lobe living donor liver transplants.

Donor safety is of paramount importance, and we cannot overemphasize it. In our series, all hepatic arterial transections were performed to protect the donor hepatic arterial supply. On occasion, when there is a single right hepatic artery but with an early bifurcation, two donor right hepatic arteries were created to the right of the common bile duct resulting in two hepatic arterial anastomosis in the recipient. In addition, all right hepatic arterial donor stumps are anastomosed in our recipients in contrast to Kishi and colleagues, where only a single anastomosis was performed if a test of sufficient back flow from another tributary was confirmed. In our latest published series 1 from July 2000 to May 2002, 95 adult right-lobe hepatectomies were performed for 95 recipients with 11 (11.6%) resultant dual hepatic arterial anastomoses. We have good recipient results and excellent donor results and have reported our preliminary short-term donor results. 2 Kishi and colleagues are to be congratulated for their good recipient results, but they did not present any short-term or long-term donor results.