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World Journal of Surgery

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Open Access 01-06-2020 | Liver Transplantation | Original Scientific Report

Impact of Hepatic Artery Variations and Reconstructions on the Outcome of Orthotopic Liver Transplantation

Authors: Rojbin Karakoyun, Antonio Romano, Ming Yao, Rafal Dlugosz, Bo-Göran Ericzon, Greg Nowak

Published in: World Journal of Surgery | Issue 6/2020

Abstract

Background

Donor variational arteries often require complex reconstruction.

Methods

We analysed the incidence of different variations, types of arterial reconstructions and their impact on post-operative results from 409 patients undergoing liver transplantation at Karolinska Institute between 2007 and 2015.

Results

A total of 292 (71.4%) liver grafts had a standard hepatic artery (SHA), and 117 (28.6%) showed hepatic artery variants (HAV). 58% of HAV needed reconstruction. The main variations were variant left hepatic artery (45.3%) from the gastric artery; variant right hepatic artery (38.5%); and a triple combination of variant right and left hepatic artery and the proper hepatic artery from the common hepatic artery (12.8%); other 3.4%. Patients/graft survival and arterial complications were not different between SHA and HAV. Incidence of biliary stricture was numerically higher in left hepatic artery variants (p = 0.058) and in variants where no arterial reconstruction was performed (p = 0.001). Operation and arterial warm ischaemia time were longer in the HAV group. The need for intraoperative re-reconstruction was higher in the HAV group (p = 0.04). Intraoperative bleeding was larger after back-table reconstruction than with intraoperative reconstruction (p = 0.04).

Conclusion

No overall differences were found between the HAV and the SHA groups. Occurrence of a variant left hepatic artery and HAV with no reconstruction seems to increase the risk of biliary strictures.

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Title: Impact of Hepatic Artery Variations and Reconstructions on the Outcome of Orthotopic Liver Transplantation
Authors: Rojbin Karakoyun
Antonio Romano
Ming Yao
Rafal Dlugosz
Bo-Göran Ericzon
Greg Nowak
Publication date: 01-06-2020
Publisher: Springer International Publishing
Keywords: Liver Transplantation
Arterial Reconstruction
Liver Transplantation
Liver Transplantation
Liver Transplantation
Liver Transplantation
Published in: World Journal of Surgery / Issue 6/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-020-05406-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Impact of Hepatic Artery Variations and Reconstructions on the Outcome of Orthotopic Liver Transplantation

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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