NDLI: Navigating complex arterial reconstruction in living donor liver transplantation: the role of the splenic artery as a viable conduit

Content Provider	Springer Nature : BioMed Central
Author	Hamed, Hosam Elshobary, Mohamed Salah, Tarek Sultan, Ahmad M. Abou El-Magd, El-sayed Elsabbagh, Ahmed M. Shehta, Ahmed Abdulrazek, Mohamed Elsarraf, Waleed Elmorshedi, Mohamed A. Abdelkhalek, Mostafa Shiha, Usama El Razek, Hassan Magdy Abd Wahab, Mohamed Abdel
Abstract	Background In living donor liver transplantation (LDLT), maintaining hepatic arterial flow is critical for graft survival. Alternative methods are required when the recipient’s hepatic artery is unsuitable due to extensive dissection or inadequate flow. This study evaluates the efficacy and safety of splenic artery transposition (SAT) for hepatic arterial reconstruction in LDLT. Methods This retrospective cohort study included 10 LDLT patients with hepatic arterial reconstruction by SAT to assess operative parameters, postoperative complications, mortality, and patency rate. Results The splenic artery was used because of arterial dissection (70%) or inadequate arterial blood flow. Operative time ranged from 640 to 1020 min, and no splenic infarction was observed. Post-operative complications were as follows; biliary leakage (10%), pancreatitis (10%), intraabdominal hemorrhage (10%), and arterial thrombosis (10%). Mortality in this cohort was 30%, one of them was due to thrombosis of the conduit and the other two died from sepsis-related complications. With a median follow-up of 43 months, this technique was associated with a 70% survival rate. Conclusion The splenic artery is a viable conduit for hepatic arterial reconstruction in LDLT, demonstrating an acceptable safety profile and complication rates. This approach is recommended in cases where the recipient’s hepatic artery is significantly compromised.
Related Links	https://bmcsurg.biomedcentral.com/counter/pdf/10.1186/s12893-024-02709-4.pdf
Ending Page	7
Page Count	7
Starting Page	1
File Format	HTM / HTML
ISSN	14712482
DOI	10.1186/s12893-024-02709-4
Journal	BMC Surgery
Issue Number	1
Volume Number	25
Language	English
Publisher	BioMed Central
Publisher Date	2025-01-06
Access Restriction	Open
Subject Keyword	Surgery Internal Medicine Living donor liver transplantation Hepatic artery Splenic artery Reconstruction
Content Type	Text
Resource Type	Article
Subject	Surgery
Journal Impact Factor	1.6/2023
5-Year Journal Impact Factor	1.9/2023

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