Analysis of Hepatic Arterial Reconstruction Technique Using Surgical Loupes for Living-Donor Liver Transplantation: Results From a Single Center


Aktas S., ALKARA U., Sevmis M., KİLERCİK H., YILDIZ H., Sevmis S.

Transplantation Proceedings, cilt.53, sa.10, ss.2929-2933, 2021 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 53 Sayı: 10
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1016/j.transproceed.2021.09.024
  • Dergi Adı: Transplantation Proceedings
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
  • Sayfa Sayıları: ss.2929-2933
  • İstanbul Yeni Yüzyıl Üniversitesi Adresli: Evet

Özet

Background: The reconstruction of the hepatic artery (HA) is the most complex step in living-donor liver transplantation (LDLT) owing to the artery's smaller diameter and the increased risk for HA-related complications. In this study, we presented our HA anastomosis technique for LDLT, which employed interrupted sutures using magnifying loupes. Materials and Methods: Since January 2019, we retrospectively analyzed 179 LDLTs that were performed at our center. HA anastomosis was performed under a loupes magnifier (2.5 or 4.5 × ) by the same surgeon. Results: There were 65 female and 114 male recipients with a mean age of 41.6 ± 21.6 years. Of the recipients, 34 were children. HA thrombosis (HAT) was seen in 3 recipients (1.67%; 1 child and 2 adults) in this series. HAT occurred on the third, sixth, and seventh days after LDLT. HAT was successfully treated with interventional radiologic technique. All recipients are still alive with a patent HA. Conclusion: The use of magnifying surgical loupes and interrupted sutures to perform HA reconstruction is safe, feasible, and yields a low rate of HAT. Also, endovascular treatment can be used safely for treatment of HAT within the first week after LDLT with a high success rate and is not associated with major complications.