Comparison of reconstruction methods used during liver transplantation in case of a graft with replaced or accessory right hepatic artery: A retrospective study

Autor: Dune Wouters, Marc Blondeau, Isabel Bos, Christophe Camus, Caroline Jezequel, Edouard Bardou‐Jacquet, Willemijn S. van der Plas, Lianne M. Nieuwenhuis, Vincent E. de Meijer, Robert J. Porte, Michel Rayar
Přispěvatelé: University of Groningen [Groningen], CHU Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
Rok vydání: 2022
Předmět:
Zdroj: Journal of Hepato-Biliary-Pancreatic Sciences
Journal of Hepato-Biliary-Pancreatic Sciences, 2022, ⟨10.1002/jhbp.1268⟩
ISSN: 1868-6982
1868-6974
DOI: 10.1002/jhbp.1268
Popis: International audience; Variations in graft arterial anatomy can increase the risk of postoperative hepatic arterial thrombosis (HAT), especially in presence of a replaced or accessory right hepatic artery (RHA). We retrospectively analyzed 223 cases of liver transplantations with the presence of an RHA on the graft. Patient outcomes were compared according to the four different reconstruction methods used: (i) the re-implantation of the RHA into the splenic or gastroduodenal artery (n = 106); (ii) the interposition of the superior mesenteric artery (SMA) (n = 83); (iii) dual anastomosis (n = 24); (iv) use of an aortic patch including the origins of both the SMA and the coeliac trunk (n = 10). A competing risk analysis and Inverse Probability Weighting (IPW) were used. We found that the interposition of the SMA method was associated with a significantly lower incidence of HAT, at 4.8% compared to the re-implantation method at 17.9%, dual anastomosis at 12.5%, and aortic patch at 20%, p = .03. In the competing risk analysis with IPW, the only risk factor for RHA thrombosis was the type of reconstruction. Taking the SMA interposition group as the reference, the sub-hazard ratio (sHR) was 5.05 (CI 95 [1.72; 14.78], p
Databáze: OpenAIRE
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