Clinical Outcomes of Donor Hepatic Artery to Recipient Replaced Right Hepatic Artery Anastomosis in Living-Donor Liver Transplantation

Objective. The aim of this work was to evaluate the clinical outcomes of donor hepatic artery to recipient replaced right hepatic artery anastomosis in living-donor liver transplantation. Methods. A retrospective analysis of 12 patients with donor hepatic artery to recipient replaced right hepatic artery anastomosis in living-donor liver transplantation from January 2012 to July 2014 was performed. Age, sex, clinical diagnosis of the liver disease, ABO mismatch, hepatic artery thrombosis, biliary strictures and leakage, graft loss, and mortality rates were evaluated. Results. Female-to-male ratio was 4:8. Right lobe was transplanted in 11(91.7%) of the patients. In 1 patient, left lobe was transplanted. In 9 patients, single duct-to-duct biliary anastomosis was performed with cystic duct catheterization. In 2 patients, double duct-to-duct biliary anastomosis was performed. In 1 patient, double biliary duct-to-duct anastomosis was performed after ductoplasty to achieve a single ductal orifice. No hepatic artery thrombosis was observed. Biliary complications were observed in 6 patients (50%: biliary leaks in 2 patients, biliary stricture in 3 patients, and both in 1 patient). ABO mismatch was not observed. No graft loss due to hepatic artery thrombosis was observed. Mortality was observed in 2 patients (16.6%). Conclusions. Donor hepatic artery to recipient replaced right hepatic artery anastomosis in living-donor liver transplantation is somewhat related to biliary complications, but not associated with increased rates of hepatic artery thrombosis.