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Liver pediatric and miscellaneous

Tuesday September 24, 2024 - 16:50 to 18:30

Room: Hamidiye

364.11 Extraanatomic arterial reconstruction during liver transplantation

Serik Turebaevich Tileuov, Kazakhstan

surgeon
Hepatopancreatobiliary Surgery and Liver Transplantation
Syzganov's National Scientific Center of Surgery

Abstract

Extraanatomic arterial reconstruction during liver transplantation

Maxat Doskhanov1, Bolatbek Baimakhanov1, Serik Tileuov1, Aidar Skakbayev1, Shokan Kaniev1, Abzal Ismatov1, Aziza Khajiyeva1, Madiyar Nagasbekov1, Zhambyl Оspan1, Shahmurat Teipov1, Daulet Marhabekov1, Zhandos Donov1.

1Hepatopancreatobiliary Surgery and Liver Transplantation, Syzganov's National Scientific Center of Surgery, Almaty city, Kazakhstan

Background: Reconstruction of the hepatic artery is the most difficult stage of liver transplantation from a living donor. Vascular complications after liver transplantation exacerbate postoperative morbidity. The aim is to evaluate the results of complex arterial reconstruction during liver transplantation in our clinic.
Methods: From December 2011 to April 2024, 279 TP was performed for adults and children at the National Research Center named after A.N. Syzganov. Living donor liver transplantation was performed in 251 (90%) patients, including pediatric liver transplantation (17.2%) cases, and deceased donor liver transplantation in 28 (10%) cases.
Postoperative complications were 99 (39.4%) cases: biliary complications 35 (14.0%), bleeding 15 (6.0%), relaparotomy 20 (8.0%), rejection was observed in 10 (4.0%) cases, non-compliance 9 (3.6%) cases, vascular complications were 21 (8.3%), of these: arterial complications 11 (4.3%), portal anastomosis 4 (1.6%), anastomoses of hepatic veins 6 (2.4%).
Results: The overall survival rate of patients after living donor liver transplantation was: 5 years– 74.3%; 10 years–71.7%. Of the 11 (4.3%) complications associated with arterial anastomosis, intraoperative were in 7 (2.7%) cases. Of these, in 6 (2.4%) cases with intimal dissection, anastomosis was performed between the graft artery and the recipient's gastro-omentum artery. In 1 (0.4%) case, extraanatomic arterial reconstruction "jump graft" with an autograft from a large saphenous vein. In the remaining 4 (1.6%) cases, they were postoperative and required complex arterial reconstruction after a typical arterial anastomosis. The success rate in all cases is 100%.
Conclusion: A good arterial anastomosis plays an important role in liver transplantation from a living donor. An alternative option for reconstruction of the hepatic artery is primarily the gastro-omentum artery. If it is impossible, other options are used (large saphenous vein, etc.).

Maxat Doskhanov.

References:

[1] Arterial reconstruction
[2] Vascular complications
[3] liver transplantation
[4] arterial anastomosis

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