Ex situ arterial reconstruction prior normothermic machine perfusion of liver grafts.
Langenbecks Arch Surg
; 407(8): 3833-3841, 2022 Dec.
Article
en En
| MEDLINE
| ID: mdl-35857097
ABSTRACT
PURPOSE:
Atypical variants of the hepatic artery are common and pose a technical challenge for normothermic machine perfusion (NMP). The transplant surgeon has three options when confronted with hepatic arterial variation in a liver graft to be subjected to NMP to perform arterial reconstruction (i) prior, (ii) during, or (iii) following NMP.METHODS:
Herein, we report our experience and technical considerations with pre-NMP reconstruction. Out of 52 livers, 9 had an atypical hepatic artery (HA) 3 replaced right HA, 3 replaced left HA, 1 accessory left HA, 1 accessory left and right HA, and 1 replaced left and right HA.RESULTS:
Reconstruction was conducted during back-table preparation. A single vascular conduit was created in all grafts to allow single arterial cannulation for NMP, necessitating only one arterial anastomosis within the recipient. All grafts were subjected to NMP and subsequently successfully transplanted.CONCLUSION:
Our approach is being advocated for as it preserves the ability to alter the reconstruction in case of problems resulting from the reconstruction itself, thereby allowing functional evaluation of the reconstruction prior transplantation, permitting simultaneous reperfusion in the recipient, and providing the shortest possible duration for vascular reconstruction once the graft is rewarming non-perfused within the recipient. In addition, in light of the frequency of technically demanding reconstructions with very small vessels, we consider our technique beneficial as the procedure can be performed under ideal conditions at the back-table.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Preservación de Órganos
/
Trasplante de Hígado
Límite:
Humans
Idioma:
En
Revista:
Langenbecks Arch Surg
Año:
2022
Tipo del documento:
Article
País de afiliación:
Alemania