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Kazemi, Kourosh; Samidoost, Pirooz; Deilami, Hamed Nikoupour; Malek-Hosseini, Seyed Ali; Nikeghbalian, Saman; Shamsaeefar, Alireza; Dehghani, Masood; Mansoorian, Mohsenreza; Gholami, Somayeh; Khosravi, Bahareh

doi:10.6002/ect.mesot2016.p82

Cited by 3 publications

(1 citation statement)

References 13 publications

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“…These results are comparatively better in comparison to other techniques. 18,19 In this study, the early mortality and 1-year survival was comparable in both groups. Till the last follow-up, all patients of the SA group are alive except for a single early mortality secondary to respiratory complication and not related to the complication of SA diversion.…”

Section: Discussionmentioning

confidence: 48%

Splenic artery transposition for hepatic arterial supply in living donor liver transplantation

et al. 2022

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Objective: To determine the safety and outcome of splenic artery(SA) transposition in extra-anatomic hepatic arterial reconstruction (HAR) in living donor liver transplantation(LDLT). Methods: We retrospectively compared the outcome of the ten liver recipients who underwent HAR with the transposed splenic artery (SA group) with a matched cohort of 40 recipients who underwent HAR with the standard hepatic artery (HA group) between March, 2019 and December, 2020 at liver transplantation department, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Pakistan. The comparison of recipients’ and donor demographics, operative and graft characteristics, post-operative labs, Doppler ultrasound(USG) findings, and complications, along with 30-day mortality, and 1-year survival were reported for both groups. Results: The mean age of patients in the SA group was 42.80±7.510 and in the HA group was 43.73±8.171 years. The common indication of LDLT was viral hepatitis in both groups. The operative duration was longer in the SA group (597.50±41.3156 min) than in the HA group (530.75±66.502 min) with a significant p-value= 0.004. Similarly, blood loss was also more in the SA group (1635±226.139 ml) than in the HA group (1477.50±270.316 ml) (p-value= 0.096). The incidence of biliary and vascular complications, early allograft dysfunction, acute cellular rejection, 30-day mortality, and 1-year survival were comparable in both groups. Post-operatively splenectomy was not needed in any SA group recipients. Conclusion: The SA is easily approachable, suitable, and safe for HAR in the difficult situation of hepatic arterial flow inadequacy during LDLT due to its appropriate length, and good blood flow. doi: https://doi.org/10.12669/pjms.39.1.6351 How to cite this: Ullah K, Dogar AW, Shams-ud-Din, Bilal H. Splenic artery transposition for hepatic arterial supply in living donor liver transplantation. Pak J Med Sci. 2023;39(1):---------. doi: https://doi.org/10.12669/pjms.39.1.6351 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 48%

Splenic artery transposition for hepatic arterial supply in living donor liver transplantation

et al. 2022

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Splenic Artery Transposition for Liver Transplantation: An Underutilized Technique?

Goss

Galván

Geha

et al. 2021

Transplantation Direct

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Background. Successful liver transplantation is dependent on restoration of hepatic arterial (HA) flow. Although uncommon, some native recipient HAs are not suitable or inadequate for anastomosis, thereby necessitating extra-anatomic HA reconstruction. Splenic artery transposition (SAT) is 1 method of HA reconstruction, in which the recipient splenic artery is transposed to reestablish perfusion of the donor liver. Due to the rarity of the technique, literature describing outcomes is limited. In the current report, we describe 3 patients (2 adults, 1 pediatric) who underwent complex upper abdominal surgery before whole-organ deceased donor liver transplantation with SAT. Methods. The demographic and patient care information was collected prospectively and subsequently reviewed retrospectively. Given the de-identified nature of the data included, this study was exempt from approval from an ethics board. Results. Recipient splenic arteries were dissected from their origin at the celiac trunk, for approximately 3–5 cm to ensure a gentle anterior-cranial curve toward the right upper quadrant, allowing anastomosis to the donor celiac trunk in an end-to-end fashion. Postoperatively, all 3 patients had rapid normalization of liver function tests and brisk HA flow demonstrated by Doppler ultrasound. Longer-term follow-up, ranging from 1 to 3 years, reveals continued patency of the reconstructed HAs and liver function tests within normal limits. Conclusions. Our experience points to SAT as a safe and effective technique for extra-anatomic HA reconstruction.

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Comparison of alternative arterial anastomosis site during liver transplantation when the recipient’s hepatic artery is unusable

Beaurepaire¹,

Orlando²,

Sandri³

et al. 2022

Hepatobiliary Surg Nutr

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Background: Few studies have analyzed outcomes of liver transplantation (LT) when the recipient hepatic artery (HA) was not usable.Methods: We retrospectively evaluated the outcomes of LT performed using the different alternative sites to HA.Results: Between 2002 and 2017, 1,677 LT were performed in our institution among which 141 (8.4%) with unusable recipient HA were analyzed. Four groups were defined according to the site of anastomosis: the splenic artery (SA group, n=26), coeliac trunk (CT group, n=12), aorta using or not the donor's vessel (Ao group, n=91) and aorta using a vascular prosthesis (Ao-P group, n=12) as conduit. The median number of intraoperative red blood cell transfusions was significantly increased in the Ao and Ao-P groups (5, 5, 8.5 and 16 for SA, CT, Ao and Ao-P group respectively, P=0.002), as well as fresh frozen plasma (4.5, 2.5, 10, 17 for the SA, CT, Ao and Ao-P groups respectively, P=0.001). Hospitalization duration was also significantly increased in the Ao and Ao-P groups (15,16,24,26.5 days for the SA, CT, Ao and Ao-P groups respectively, P<0.001). The occurrence of early allograft dysfunction (EAD) (P=0.07) or arterial complications (P=0.26) was not statistically different. Level of factor V, INR, bilirubin and creatinine during the 7 th postoperative days (POD) was significantly improved in the SA group. No difference was observed regarding graft (P=0.18)and patient (P=0.16) survival.Conclusions: In case of unusable HA, intraoperative and postoperative outcomes are improved when using the SA or CT compared to aorta.

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Cited by 3 publications

References 13 publications

Splenic artery transposition for hepatic arterial supply in living donor liver transplantation

Splenic artery transposition for hepatic arterial supply in living donor liver transplantation

Splenic Artery Transposition for Liver Transplantation: An Underutilized Technique?

Comparison of alternative arterial anastomosis site during liver transplantation when the recipient’s hepatic artery is unusable

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