Reconstruction of Type V Hepatic Arterial in the Adult and Pediatric Liver Transplant Recipient

John Abraham Geha; Matthew Benjamin Goss; Joseph Daniel Geha; Christine Ann O’Mahony; Nhu Thao Nguyen Galvan; Abbas Rana; Ronald Timothy Cotton; Michael Louis Kueht; John Allen Goss

doi:doi:10.11648/j.js.20200801.11

Reconstruction of Type V Hepatic Arterial in the Adult and Pediatric Liver Transplant Recipient

John Abraham Geha, Matthew Benjamin Goss, Joseph Daniel Geha, Christine Ann O’Mahony, Nhu Thao Nguyen Galvan, Abbas Rana, Ronald Timothy Cotton, Michael Louis Kueht, John Allen Goss

Published in Journal of Surgery (Volume 8, Issue 1)

Received: 24 November 2019 Accepted: 3 January 2020 Published: 13 January 2020

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Abstract

The replaced common hepatic artery (RCHA) is an uncommon arterial anomaly that, when present, makes hepatic arterial reconstruction during liver transplantation technically challenging. At our institution, the reconstruction of the recipient RCHA consists of 2 techniques that include either an infrarenal donor iliac artery aortic conduit or a direct donor celiac trunk anastomosis to the proximal RCHA. Our experience demonstrates that the direct anastomosis to the RCHA provides a reliable source of arterial inflow, allows preservation of the recipient arterial anatomy, and minimizes the dissection required to create an infrarenal aortic conduit. Between September 1998 and April 2019, we performed 1782 liver transplants (1230 adults, >18 years; 552 pediatric, <18 years). There were 36 (2.92%) adult and 20 (3.07%) pediatric liver transplant recipients that possessed a RCHA. Allograft and patient survivals were 94.70% and 94.10%, in both the infrarenal conduit and direct Type-V anastomosis cohorts at 1 year, respectively. To date, hepatic artery thrombosis (HAT) has not occurred in the 2 cohorts of pediatric transplant recipients. In conclusion, the direct donor celiac trunk to RCHA anastomosis is a safe and effective way to perform arterial reconstruction with low hepatic artery thrombosis and biliary complication rates.

Published in	Journal of Surgery (Volume 8, Issue 1)
DOI	10.11648/j.js.20200801.11
Page(s)	1-4
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Liver Transplantation, Arterial Reconstruction, Arterial Anomaly

References

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APA Style

John Abraham Geha, Matthew Benjamin Goss, Joseph Daniel Geha, Christine Ann O’Mahony, Nhu Thao Nguyen Galvan, et al. (2020). Reconstruction of Type V Hepatic Arterial in the Adult and Pediatric Liver Transplant Recipient. Journal of Surgery, 8(1), 1-4. https://doi.org/10.11648/j.js.20200801.11

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ACS Style

John Abraham Geha; Matthew Benjamin Goss; Joseph Daniel Geha; Christine Ann O’Mahony; Nhu Thao Nguyen Galvan, et al. Reconstruction of Type V Hepatic Arterial in the Adult and Pediatric Liver Transplant Recipient. J. Surg. 2020, 8(1), 1-4. doi: 10.11648/j.js.20200801.11

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AMA Style

John Abraham Geha, Matthew Benjamin Goss, Joseph Daniel Geha, Christine Ann O’Mahony, Nhu Thao Nguyen Galvan, et al. Reconstruction of Type V Hepatic Arterial in the Adult and Pediatric Liver Transplant Recipient. J Surg. 2020;8(1):1-4. doi: 10.11648/j.js.20200801.11

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@article{10.11648/j.js.20200801.11,
  author = {John Abraham Geha and Matthew Benjamin Goss and Joseph Daniel Geha and Christine Ann O’Mahony and Nhu Thao Nguyen Galvan and Abbas Rana and Ronald Timothy Cotton and Michael Louis Kueht and John Allen Goss},
  title = {Reconstruction of Type V Hepatic Arterial in the Adult and Pediatric Liver Transplant Recipient},
  journal = {Journal of Surgery},
  volume = {8},
  number = {1},
  pages = {1-4},
  doi = {10.11648/j.js.20200801.11},
  url = {https://doi.org/10.11648/j.js.20200801.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20200801.11},
  abstract = {The replaced common hepatic artery (RCHA) is an uncommon arterial anomaly that, when present, makes hepatic arterial reconstruction during liver transplantation technically challenging. At our institution, the reconstruction of the recipient RCHA consists of 2 techniques that include either an infrarenal donor iliac artery aortic conduit or a direct donor celiac trunk anastomosis to the proximal RCHA. Our experience demonstrates that the direct anastomosis to the RCHA provides a reliable source of arterial inflow, allows preservation of the recipient arterial anatomy, and minimizes the dissection required to create an infrarenal aortic conduit. Between September 1998 and April 2019, we performed 1782 liver transplants (1230 adults, >18 years; 552 pediatric, <18 years). There were 36 (2.92%) adult and 20 (3.07%) pediatric liver transplant recipients that possessed a RCHA. Allograft and patient survivals were 94.70% and 94.10%, in both the infrarenal conduit and direct Type-V anastomosis cohorts at 1 year, respectively. To date, hepatic artery thrombosis (HAT) has not occurred in the 2 cohorts of pediatric transplant recipients. In conclusion, the direct donor celiac trunk to RCHA anastomosis is a safe and effective way to perform arterial reconstruction with low hepatic artery thrombosis and biliary complication rates.},
 year = {2020}
}

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TY  - JOUR
T1  - Reconstruction of Type V Hepatic Arterial in the Adult and Pediatric Liver Transplant Recipient
AU  - John Abraham Geha
AU  - Matthew Benjamin Goss
AU  - Joseph Daniel Geha
AU  - Christine Ann O’Mahony
AU  - Nhu Thao Nguyen Galvan
AU  - Abbas Rana
AU  - Ronald Timothy Cotton
AU  - Michael Louis Kueht
AU  - John Allen Goss
Y1  - 2020/01/13
PY  - 2020
N1  - https://doi.org/10.11648/j.js.20200801.11
DO  - 10.11648/j.js.20200801.11
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 1
EP  - 4
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20200801.11
AB  - The replaced common hepatic artery (RCHA) is an uncommon arterial anomaly that, when present, makes hepatic arterial reconstruction during liver transplantation technically challenging. At our institution, the reconstruction of the recipient RCHA consists of 2 techniques that include either an infrarenal donor iliac artery aortic conduit or a direct donor celiac trunk anastomosis to the proximal RCHA. Our experience demonstrates that the direct anastomosis to the RCHA provides a reliable source of arterial inflow, allows preservation of the recipient arterial anatomy, and minimizes the dissection required to create an infrarenal aortic conduit. Between September 1998 and April 2019, we performed 1782 liver transplants (1230 adults, >18 years; 552 pediatric, <18 years). There were 36 (2.92%) adult and 20 (3.07%) pediatric liver transplant recipients that possessed a RCHA. Allograft and patient survivals were 94.70% and 94.10%, in both the infrarenal conduit and direct Type-V anastomosis cohorts at 1 year, respectively. To date, hepatic artery thrombosis (HAT) has not occurred in the 2 cohorts of pediatric transplant recipients. In conclusion, the direct donor celiac trunk to RCHA anastomosis is a safe and effective way to perform arterial reconstruction with low hepatic artery thrombosis and biliary complication rates.
VL  - 8
IS  - 1
ER  -

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Author Information

John Abraham Geha

Division of Abdominal Transplantation, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, USA
Matthew Benjamin Goss

John P. and Katherine G. McGovern Medical School, University of Texas Health Science Center at Houston, Houston, USA
Joseph Daniel Geha

Division of Abdominal Transplantation, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, USA
Christine Ann O’Mahony

Division of Abdominal Transplantation, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, USA
Nhu Thao Nguyen Galvan

Division of Abdominal Transplantation, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, USA
Abbas Rana

Division of Abdominal Transplantation, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, USA
Ronald Timothy Cotton

Division of Abdominal Transplantation, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, USA
Michael Louis Kueht

Division of Abdominal Transplantation, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, USA
John Allen Goss

Division of Abdominal Transplantation, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, USA

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Plain Text BibTeX RIS

APA Style

John Abraham Geha, Matthew Benjamin Goss, Joseph Daniel Geha, Christine Ann O’Mahony, Nhu Thao Nguyen Galvan, et al. (2020). Reconstruction of Type V Hepatic Arterial in the Adult and Pediatric Liver Transplant Recipient. Journal of Surgery, 8(1), 1-4. https://doi.org/10.11648/j.js.20200801.11

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ACS Style

John Abraham Geha; Matthew Benjamin Goss; Joseph Daniel Geha; Christine Ann O’Mahony; Nhu Thao Nguyen Galvan, et al. Reconstruction of Type V Hepatic Arterial in the Adult and Pediatric Liver Transplant Recipient. J. Surg. 2020, 8(1), 1-4. doi: 10.11648/j.js.20200801.11

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AMA Style

John Abraham Geha, Matthew Benjamin Goss, Joseph Daniel Geha, Christine Ann O’Mahony, Nhu Thao Nguyen Galvan, et al. Reconstruction of Type V Hepatic Arterial in the Adult and Pediatric Liver Transplant Recipient. J Surg. 2020;8(1):1-4. doi: 10.11648/j.js.20200801.11

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@article{10.11648/j.js.20200801.11,
  author = {John Abraham Geha and Matthew Benjamin Goss and Joseph Daniel Geha and Christine Ann O’Mahony and Nhu Thao Nguyen Galvan and Abbas Rana and Ronald Timothy Cotton and Michael Louis Kueht and John Allen Goss},
  title = {Reconstruction of Type V Hepatic Arterial in the Adult and Pediatric Liver Transplant Recipient},
  journal = {Journal of Surgery},
  volume = {8},
  number = {1},
  pages = {1-4},
  doi = {10.11648/j.js.20200801.11},
  url = {https://doi.org/10.11648/j.js.20200801.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20200801.11},
  abstract = {The replaced common hepatic artery (RCHA) is an uncommon arterial anomaly that, when present, makes hepatic arterial reconstruction during liver transplantation technically challenging. At our institution, the reconstruction of the recipient RCHA consists of 2 techniques that include either an infrarenal donor iliac artery aortic conduit or a direct donor celiac trunk anastomosis to the proximal RCHA. Our experience demonstrates that the direct anastomosis to the RCHA provides a reliable source of arterial inflow, allows preservation of the recipient arterial anatomy, and minimizes the dissection required to create an infrarenal aortic conduit. Between September 1998 and April 2019, we performed 1782 liver transplants (1230 adults, >18 years; 552 pediatric, <18 years). There were 36 (2.92%) adult and 20 (3.07%) pediatric liver transplant recipients that possessed a RCHA. Allograft and patient survivals were 94.70% and 94.10%, in both the infrarenal conduit and direct Type-V anastomosis cohorts at 1 year, respectively. To date, hepatic artery thrombosis (HAT) has not occurred in the 2 cohorts of pediatric transplant recipients. In conclusion, the direct donor celiac trunk to RCHA anastomosis is a safe and effective way to perform arterial reconstruction with low hepatic artery thrombosis and biliary complication rates.},
 year = {2020}
}

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TY  - JOUR
T1  - Reconstruction of Type V Hepatic Arterial in the Adult and Pediatric Liver Transplant Recipient
AU  - John Abraham Geha
AU  - Matthew Benjamin Goss
AU  - Joseph Daniel Geha
AU  - Christine Ann O’Mahony
AU  - Nhu Thao Nguyen Galvan
AU  - Abbas Rana
AU  - Ronald Timothy Cotton
AU  - Michael Louis Kueht
AU  - John Allen Goss
Y1  - 2020/01/13
PY  - 2020
N1  - https://doi.org/10.11648/j.js.20200801.11
DO  - 10.11648/j.js.20200801.11
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 1
EP  - 4
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20200801.11
AB  - The replaced common hepatic artery (RCHA) is an uncommon arterial anomaly that, when present, makes hepatic arterial reconstruction during liver transplantation technically challenging. At our institution, the reconstruction of the recipient RCHA consists of 2 techniques that include either an infrarenal donor iliac artery aortic conduit or a direct donor celiac trunk anastomosis to the proximal RCHA. Our experience demonstrates that the direct anastomosis to the RCHA provides a reliable source of arterial inflow, allows preservation of the recipient arterial anatomy, and minimizes the dissection required to create an infrarenal aortic conduit. Between September 1998 and April 2019, we performed 1782 liver transplants (1230 adults, >18 years; 552 pediatric, <18 years). There were 36 (2.92%) adult and 20 (3.07%) pediatric liver transplant recipients that possessed a RCHA. Allograft and patient survivals were 94.70% and 94.10%, in both the infrarenal conduit and direct Type-V anastomosis cohorts at 1 year, respectively. To date, hepatic artery thrombosis (HAT) has not occurred in the 2 cohorts of pediatric transplant recipients. In conclusion, the direct donor celiac trunk to RCHA anastomosis is a safe and effective way to perform arterial reconstruction with low hepatic artery thrombosis and biliary complication rates.
VL  - 8
IS  - 1
ER  -

Copy | Download