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Background <p>In living donor liver transplantation (LDLT), maintaining hepatic arterial flow is critical for graft survival. Alternative methods are required when the recipient’s hepatic artery is unsuitable due to extensive dissection or inadequate flow. This study evaluates the efficacy and safety of splenic artery transposition (SAT) for hepatic arterial reconstruction in LDLT.</p> Methods <p>This retrospective cohort study included 10 LDLT patients with hepatic arterial reconstruction by SAT to assess operative parameters, postoperative complications, mortality, and patency rate.</p> Results <p>The splenic artery was used because of arterial dissection (70%) or inadequate arterial blood flow. Operative time ranged from 640 to 1020&#xa0;min, and no splenic infarction was observed. Post-operative complications were as follows; biliary leakage (10%), pancreatitis (10%), intraabdominal hemorrhage (10%), and arterial thrombosis (10%). Mortality in this cohort was 30%, one of them was due to thrombosis of the conduit and the other two died from sepsis-related complications. With a median follow-up of 43 months, this technique was associated with a 70% survival rate.</p> Conclusion <p>The splenic artery is a viable conduit for hepatic arterial reconstruction in LDLT, demonstrating an acceptable safety profile and complication rates. This approach is recommended in cases where the recipient’s hepatic artery is significantly compromised.</p>

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Navigating complex arterial reconstruction in living donor liver transplantation: the role of the splenic artery as a viable conduit

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年1月6日

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  • Hosam Hamed,
  • Mohamed Elshobary,
  • Tarek Salah,
  • Ahmad M. Sultan,
  • El-sayed Abou El-Magd,
  • Ahmed M. Elsabbagh,
  • Ahmed Shehta,
  • Mohamed Abdulrazek,
  • Waleed Elsarraf,
  • Mohamed A. Elmorshedi,
  • Mostafa Abdelkhalek,
  • Usama Shiha,
  • Hassan Magdy Abd El Razek,
  • Mohamed Abdel Wahab

摘要

Background

In living donor liver transplantation (LDLT), maintaining hepatic arterial flow is critical for graft survival. Alternative methods are required when the recipient’s hepatic artery is unsuitable due to extensive dissection or inadequate flow. This study evaluates the efficacy and safety of splenic artery transposition (SAT) for hepatic arterial reconstruction in LDLT.

Methods

This retrospective cohort study included 10 LDLT patients with hepatic arterial reconstruction by SAT to assess operative parameters, postoperative complications, mortality, and patency rate.

Results

The splenic artery was used because of arterial dissection (70%) or inadequate arterial blood flow. Operative time ranged from 640 to 1020 min, and no splenic infarction was observed. Post-operative complications were as follows; biliary leakage (10%), pancreatitis (10%), intraabdominal hemorrhage (10%), and arterial thrombosis (10%). Mortality in this cohort was 30%, one of them was due to thrombosis of the conduit and the other two died from sepsis-related complications. With a median follow-up of 43 months, this technique was associated with a 70% survival rate.

Conclusion

The splenic artery is a viable conduit for hepatic arterial reconstruction in LDLT, demonstrating an acceptable safety profile and complication rates. This approach is recommended in cases where the recipient’s hepatic artery is significantly compromised.