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Intraoperative hepatic artery thrombosis in living donor liver transplantation despite immediate reconstruction increases risk of graft failure

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AHBPS

Annals of Hepato-Biliary-Pancreatic Surgery

www.ahbps.org S52

Intraoperative hepatic artery thrombosis in living donor liver transplantation despite immediate

reconstruction increases risk of graft failure

Su young HONG

1

, Nam-Joon YI*

,1

, Kwangpyo HONG

1

, Eui Soo HAN

1

, Sanggyun SUH

1

, Jeong-Moo LEE

1

, Suk Kyun HONG

1

, YoungRok CHOI

1

, Ung Sik JIN

2

, Hak CHANG

2

, Kwang-Woong LEE

1

, Kyung-Suk SUH

1

1

Department of Surgery, Seoul National University College of Medicine, Seoul, Korea

2

Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea

LV-OP-1-7

Introduction: Post-transplant hepatic artery thrombosis (HAT) can lead serious complications of are derived from long arterial isch- emic time. However, there has been few reports regarding fate of intraoperative HAT during adult living donor liver transplantation (ALDLT).

Methods: From 2000 to 2019, 1,355 recipients underwent ALDLT in Seoul National University Hospital. All patients with no intra- operative arterial flow were managed by redoing hepatic artery anastomosis. Survival outcomes and the rates of biliary complication of patients with intraoperative HAT were compared with others without HAT and with postoperative HAT. Median follow-up period was 89 months.

Results: Intraoperative HAT was developed in 45 cases (3.3%). Hepatic artery reanastomosis was performed once in 33 cases (73.3%), for more than 2 times in 12 cases (26.6%). Among 45 patients with intraoperative HAT, postoperative HAT was detected in 6 cases (13.3%). All patients underwent redo arterial reconstruction, but technical success rate was 50.0%. Overall graft survival rates were lower in patients with intraoperative HAT (93.3%) than others without HAT (98.0%) ( p = 0.026), but higher than in patients with post- operative HAT (88.9%) ( p = 0.001). However, patient survival rates were similar among three groups (p = 0.269). There was no differ- ence in biliary complication between patients with intraoperative HAT (33.3%) and the others without HAT (32.1%) ( p = 0.945), lower than patients with postoperative HAT (55.5%, p = 0.011).

Conclusions: Intraoperative HAT after ALDLT did not affect biliary complication and patient survival, but is significantly associated with recurrent postoperative HAT and graft failure. Patients with intraoperative HAT in ALDLT should be intensively monitored for HAT and graft dysfunction.

pISSN: 2508-5778ㆍeISSN: 2508-5859

Ann Hepatobiliary Pancreat Surg 2021;25 Suppl 1:S52 https://doi.org/10.14701/ahbps.LV-OP-1-7

Corresponding Author: Nam-Joon YI (gsleenj@gmail.com) Presenter: Su young HONG (sypurple@gmail.com)

Copyright Ⓒ The Korean Association of Hepato-Biliary-Pancreatic Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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