Effect of hepatic artery reconstruction techniques on prognosis of liver transplantation
10.3969/j.issn.1674-7445.2023.01.017
- VernacularTitle:肝动脉重建技术对肝移植预后的影响
- Author:
Xincheng LI
1
;
Fan HUANG
;
Guobin WANG
;
Xiaojun YU
;
Ruolin WU
;
Liujin HOU
;
Zhenghui YE
;
Xinghua ZHANG
;
Wei WANG
;
Xiaoping GENG
;
Hongchuan ZHAO
Author Information
1. Organ Transplantation Center, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
- Publication Type:Research Article
- Keywords:
Liver transplantation;
Hepatic artery reconstruction;
Hepatic artery complication;
Intensive care unit;
Total bilirubin;
Alanine aminotransferase;
Aspartate aminotransferase;
Prothrombin time international normalized ratio
- From:
Organ Transplantation
2023;14(1):128-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of different techniques of hepatic artery reconstruction on postoperative hepatic artery complications and clinical prognosis in liver transplantation. Methods Clinical data of 140 liver transplant recipients were retrospectively analyzed. All recipients were divided into the conventional hepatic artery reconstruction group (n=123) and special hepatic artery reconstruction group (n=17) according to hepatic artery reconstruction methods. Intraoperative and postoperative clinical indexes, the incidence of postoperative hepatic artery complications and survival rate were compared between two groups. Results The alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels at postoperative 1 d, total bilirubin (TB) at postoperative 7 d and prothrombin time international normalized ratio (PT-INR) at postoperative 30 d in special hepatic artery reconstruction group were higher than those in conventional hepatic artery reconstruction group, and the differences were statistically significant (all P < 0.05). There were no significant differences in the operation time, anhepatic phase, intraoperative blood loss, intraoperative transfusion volume of red blood cells, cold or warm ischemia time, the length of intensive care unit (ICU) stay, the length of hospital stay and postoperative blood flow of liver allograft between two groups (all P > 0.05). In the conventional hepatic artery reconstruction group, 5 recipients developed hepatic artery complications, whereas no hepatic artery complications occurred in the special hepatic artery reconstruction group, with no significant difference between two groups (P > 0.05). In the special hepatic artery reconstruction group, the 1-, 3- and 5-year cumulative survival rates were equally 82.4%, compared with 85.0%, 78.9% and 75.6% in the conventional hepatic artery reconstruction group, respectively. There was no significant difference between two groups (all P > 0.05). Conclusions When hepatic artery variations and (or) lesions are detected in donors and recipients, use of special hepatic artery reconstruction may effectively restore the hepatic arterial blood flow of liver allograft after liver transplantation, and will not affect the incidence of hepatic artery complications and survival rate of the recipients following liver transplantation.
