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KMID : 0361120210350030183
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Korean Journal of Transplantation
2021 Volume.35 No. 3 p.183 ~ p.188
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Hepatic artery reconstruction using interposition of autologous saphenous vein conduit for living donor liver transplantation: a case report
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Moon Deok-Bog
Hwang Shin
Jung Dong-Hwan
Ahn Chul-Soo
Park Gil-Chun
Ha Tae-Yong
Song Gi-Won
Yoon Young-In
Lee Sung-Gyu
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Abstract
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We have preferentially used the right gastroepiploic artery (RGEA) as an alternative for the recipient hepatic artery (HA) inflow during living donor liver transplantation (LDLT), but it was not always available. We herein present a case of adult LDLT with HA reconstruction using a greater saphenous vein (GSV) conduit because of the absence of the RGEA due to prior subtotal gastrectomy. A 55-year-old male patient diagnosed with hepatitis B virus-associated liver cirrhosis and secondary biliary cirrhosis underwent LDLT using a modified right liver graft. The upper abdominal cavity was heavily adhered due to prior abdominal surgeries, thus we had to sacrifice the common bile duct and the right HA completely. A 6-cm-long GSV segment was harvested from the left ankle and interposed between the recipient gastroduodenal artery and the graft HA. The patient recovered from LDLT and HA complications did not occur. However, 8 years after LDLT, chronic rejection occurred, thus repeated deceased donor liver transplantation was performed. This patient has been doing well for 2 years after retransplantation. In conclusion, we suggest that interposition of an autologous GSV conduit can be an alternative for establishing HA inflow in LDLT when other inflow source is not available.
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KEYWORD
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Liver transplantation, Hepatic artery thrombosis, Vascular interposition, Living donor, Saphenous vein, Case report
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