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Transplant Proc ; 51(9): 3120-3123, 2019 Nov.
Article in English | MEDLINE | ID: mdl-31611118

ABSTRACT

BACKGROUND: In living-donor liver transplantation (LDLT), successful microsurgical arterial reconstruction is essential but quite challenging. Dissection of the hepatic artery extending to the celiac trunk is a rare complication during liver transplantation. Kazakhstan is an area in which deceased donor grafts are not sufficient for several reasons, and the availability of graft vessels is limited. METHODS: We herein report the case of a 65-year-old patient who underwent LDLT due to hepatitis B + D virus-coinfected liver cirrhosis complicated by hepatic artery dissection extending to the celiac trunk. Because of massive gastric collateral varices, direct anastomosis to the supraceliac aorta was not possible. Therefore, extra-anatomic jump graft reconstruction was performed from the right iliac artery to the graft's hepatic artery using an autologous graft vein (great saphenous vein). RESULTS: The patient's postoperative period was uneventful. The patient was discharged at 27 days post-transplantation. At the time of writing, the follow-up period is 8 months after transplantation, and the recipient maintains a normal liver function. CONCLUSION: When there is no other option for arterial reconstruction, this method is a feasible option for performing extra-anatomic jump graft reconstruction.


Subject(s)
Liver Transplantation/methods , Plastic Surgery Procedures/methods , Saphenous Vein/transplantation , Vascular Surgical Procedures/methods , Adult , Aged , Aortic Dissection/surgery , Female , Hepatic Artery/pathology , Humans , Living Donors , Male , Middle Aged , Transplantation, Autologous/methods
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