07 January 2025 : Original article
Arterial Reconstruction Using the Right Gastroepiploic Artery in Living Donor Liver Transplantation: A Single-Center Experience
Takanobu Hara
ABCDEF 1*, Akihiko Soyama CD 1, Hajime Matsushima CD 1, Takashi Hamada BC 1, Ayaka Kinoshita BC 1, Hajime Imamura BC 1, Mampei Yamashita BC 1, Ayaka Satoh B 1, Kazushige Migita B 1, Yuta Kawaguchi B 1, Tomohiko Adachi D 1, Mitsuhisa Takatsuki AE 2, Susumu Eguchi AE 1
DOI: 10.12659/AOT.946135
Ann Transplant 2025; 30:e946135
Table 1 Patient characteristics.
| Valuables | Total n=324 | Primary arterial reconstruction | P | |
|---|---|---|---|---|
| RGEA, n=18 | HA, n=306 | |||
| Recipient sex, male | 180 (55.6%) | 8 (44.4%) | 172 (56.2%) | 0.23 |
| Recipient age, y* | 57 (50–63) | 57 (52–63) | 57 (50–63) | 0.79 |
| Donor age, y* | 39 (30–51) | 38 (33–43) | 39 (30–52) | 0.75 |
| MELD score* | 16 (12–23) | 17 (14–22) | 16 (12–23) | 0.60 |
| Child-Pugh score* | 10 (9–12) | 11 (9–12) | 10 (9–12) | 0.93 |
| HCV infection | 90 (27.8%) | 4 (22.2%) | 86 (28.1%) | 0.41 |
| HCC | 123 (38.0%) | 5 (27.8%) | 118 (38.6%) | 0.26 |
| TACE | 38 (11.7%) | 3 (16.7%) | 35 (11.4%) | 0.36 |
| Pretransplant dialysis | 37 (11.4%) | 2 (11.1%) | 35 (11.4%) | 0.66 |
| History of upper abdominal surgery | 58 (17.9%) | 4 (22.2%) | 54 (17.6%) | 0.42 |
| ABO incompatible | 65 (20.1%) | 3 (16.7%) | 62 (20.3%) | 0.50 |
| GV/SLV,%* | 46.2 (38.4–55.8) | 47.8 (41.0–61.3) | 46.1 (38.2–55.7) | 0.22 |
| Graft type | ||||
| Left lateral section | 13 (4.0%) | 0 | 13 (4.2%) | 0.49 |
| Left lobe | 172 (53.1%) | 9 (50.0%) | 163 (53.3%) | |
| Right lobe | 128 (39.5%) | 9 (50.0%) | 119 (38.9%) | |
| Right posterior section | 11 (3.4%) | 0 | 11 (3.6%) | |
| Hepaticojejunostomy | 36 (11.1%) | 2 (11.1%) | 34 (11.1%) | 0.65 |
| Splenectomy | 142 (43.8%) | 8 (44.4%) | 134 (43.8%) | 0.57 |
| Operative time, min* | 806 (723–900) | 921 (852–1,075) | 802 (721–895) | <0.001 |
| Blood loss, L* | 6.4 (3.5–11.2) | 6.0 (3.4–11.0) | 7.9 (5.1–12.1) | 0.10 |
| RBC transfusion, unit* | 14 (6–24) | 16 (14–22) | 12 (6–24) | 0.18 |
| Arterial complication | 16 (4.9%) | 4 (22.2%) | 12 (3.9%) | 0.01 |
| HAT | 11 (3.4%) | 3 (16.7%) | 8 (2.6%) | |
| Bleeding | 3 (0.9%) | 1 (5.6%) | 2 (0.7%) | |
| Intimal dissection | 2 (0.6%) | 0 | 2 (0.7%) | |
| Biliary strictures | 59 (18.2%) | 5 (27.8%) | 54 (17.6%) | 0.21 |
| Anastomotic strictures | 58 (17.9%) | 5 (27.8%) | 53 (17.3%) | |
| Non-anastomotic strictures | 1 (0.3%) | 0 | 1 (0.3%) | |
| Biliary anastomotic leakage | 11 (3.4%) | 0 | 11 (3.6%) | 0.53 |
| Length of posttransplant hospital stay | 48 (36–70) | 57 (46–77) | 47 (36–70) | 0.12 |
| Data represented as n (%) unless otherwise specified. * Median (interquartile range range). RGEA – right gastroepiploic artery; HA – hepatic artery; MELD – model for end-stage liver disease; HCV – hepatitis virus C; HCC – hepatocellular carcinoma; TACE – transarterial chemoembolization; GV – graft volume; SLV – standard liver volume; RBC – red blood cell; HAT – hepatic artery thrombosis. | ||||