Long-Term Suitability of Left Gastric Artery Inflow for Arterial Perfusion of Living Donor Right Lobe Grafts

Poorer than expected, living donor liver transplant outcomes are observed after recipient graft artery thrombosis. At grafting, the risk for later thrombosis is high if a dissected hepatic artery is used for standard reconstruction. Surgeon diagnosis of dissection requires nonstandard management wit...

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Main Authors: Judyta A. Lipinska, Johnny Wang, Joseph N. Carey, Aaron A. Ahearn, Yuri S. Genyk
Format: Article
Language:English
Published: Hindawi Limited 2022-01-01
Series:Case Reports in Transplantation
Online Access:http://dx.doi.org/10.1155/2022/9421648
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author Judyta A. Lipinska
Johnny Wang
Joseph N. Carey
Aaron A. Ahearn
Yuri S. Genyk
author_facet Judyta A. Lipinska
Johnny Wang
Joseph N. Carey
Aaron A. Ahearn
Yuri S. Genyk
author_sort Judyta A. Lipinska
collection DOAJ
description Poorer than expected, living donor liver transplant outcomes are observed after recipient graft artery thrombosis. At grafting, the risk for later thrombosis is high if a dissected hepatic artery is used for standard reconstruction. Surgeon diagnosis of dissection requires nonstandard management with alternative technique in addition to microvascular expertise. Intimal flap repair with standard reconstruction is contingent on basis of a redo anastomosis. It is a suboptimal choice for living donor transplantation. Achieving goal graft arterial perfusion at first revascularization is crucial for superior outcomes. Managing dissection at grafting with nonstandard left gastric artery reconstruction is unreported. Our experience is limited, but this is our preferred alternative technique to standard hepatic artery reconstruction complicated by dissection. Here, we describe our two-case experience with left gastric arterialized grafts for management of dissection. Our living donor graft recipients with alternatively arterialized grafts are now 6- and 2-years posttransplant.
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spelling doaj.art-25b7389cf1954ff28dd32d66f6cc30102022-12-22T04:19:30ZengHindawi LimitedCase Reports in Transplantation2090-69512022-01-01202210.1155/2022/9421648Long-Term Suitability of Left Gastric Artery Inflow for Arterial Perfusion of Living Donor Right Lobe GraftsJudyta A. Lipinska0Johnny Wang1Joseph N. Carey2Aaron A. Ahearn3Yuri S. Genyk4Department of SurgeryDepartment of SurgeryDepartment of SurgeryDepartment of SurgeryDepartment of SurgeryPoorer than expected, living donor liver transplant outcomes are observed after recipient graft artery thrombosis. At grafting, the risk for later thrombosis is high if a dissected hepatic artery is used for standard reconstruction. Surgeon diagnosis of dissection requires nonstandard management with alternative technique in addition to microvascular expertise. Intimal flap repair with standard reconstruction is contingent on basis of a redo anastomosis. It is a suboptimal choice for living donor transplantation. Achieving goal graft arterial perfusion at first revascularization is crucial for superior outcomes. Managing dissection at grafting with nonstandard left gastric artery reconstruction is unreported. Our experience is limited, but this is our preferred alternative technique to standard hepatic artery reconstruction complicated by dissection. Here, we describe our two-case experience with left gastric arterialized grafts for management of dissection. Our living donor graft recipients with alternatively arterialized grafts are now 6- and 2-years posttransplant.http://dx.doi.org/10.1155/2022/9421648
spellingShingle Judyta A. Lipinska
Johnny Wang
Joseph N. Carey
Aaron A. Ahearn
Yuri S. Genyk
Long-Term Suitability of Left Gastric Artery Inflow for Arterial Perfusion of Living Donor Right Lobe Grafts
Case Reports in Transplantation
title Long-Term Suitability of Left Gastric Artery Inflow for Arterial Perfusion of Living Donor Right Lobe Grafts
title_full Long-Term Suitability of Left Gastric Artery Inflow for Arterial Perfusion of Living Donor Right Lobe Grafts
title_fullStr Long-Term Suitability of Left Gastric Artery Inflow for Arterial Perfusion of Living Donor Right Lobe Grafts
title_full_unstemmed Long-Term Suitability of Left Gastric Artery Inflow for Arterial Perfusion of Living Donor Right Lobe Grafts
title_short Long-Term Suitability of Left Gastric Artery Inflow for Arterial Perfusion of Living Donor Right Lobe Grafts
title_sort long term suitability of left gastric artery inflow for arterial perfusion of living donor right lobe grafts
url http://dx.doi.org/10.1155/2022/9421648
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