Navigating complex arterial reconstruction in living donor liver transplantation: the role of the splenic artery as a viable conduit
Abstract Background In living donor liver transplantation (LDLT), maintaining hepatic arterial flow is critical for graft survival. Alternative methods are required when the recipient’s hepatic artery is unsuitable due to extensive dissection or inadequate flow. This study evaluates the efficacy and...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s12893-024-02709-4 |
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| author | Hosam Hamed Mohamed Elshobary Tarek Salah Ahmad M. Sultan El-sayed Abou El-Magd Ahmed M. Elsabbagh Ahmed Shehta Mohamed Abdulrazek Waleed Elsarraf Mohamed A. Elmorshedi Mostafa Abdelkhalek Usama Shiha Hassan Magdy Abd El Razek Mohamed Abdel Wahab |
| author_facet | Hosam Hamed Mohamed Elshobary Tarek Salah Ahmad M. Sultan El-sayed Abou El-Magd Ahmed M. Elsabbagh Ahmed Shehta Mohamed Abdulrazek Waleed Elsarraf Mohamed A. Elmorshedi Mostafa Abdelkhalek Usama Shiha Hassan Magdy Abd El Razek Mohamed Abdel Wahab |
| author_sort | Hosam Hamed |
| collection | DOAJ |
| description | Abstract Background In living donor liver transplantation (LDLT), maintaining hepatic arterial flow is critical for graft survival. Alternative methods are required when the recipient’s hepatic artery is unsuitable due to extensive dissection or inadequate flow. This study evaluates the efficacy and safety of splenic artery transposition (SAT) for hepatic arterial reconstruction in LDLT. Methods This retrospective cohort study included 10 LDLT patients with hepatic arterial reconstruction by SAT to assess operative parameters, postoperative complications, mortality, and patency rate. Results The splenic artery was used because of arterial dissection (70%) or inadequate arterial blood flow. Operative time ranged from 640 to 1020 min, and no splenic infarction was observed. Post-operative complications were as follows; biliary leakage (10%), pancreatitis (10%), intraabdominal hemorrhage (10%), and arterial thrombosis (10%). Mortality in this cohort was 30%, one of them was due to thrombosis of the conduit and the other two died from sepsis-related complications. With a median follow-up of 43 months, this technique was associated with a 70% survival rate. Conclusion The splenic artery is a viable conduit for hepatic arterial reconstruction in LDLT, demonstrating an acceptable safety profile and complication rates. This approach is recommended in cases where the recipient’s hepatic artery is significantly compromised. |
| format | Article |
| id | doaj-art-46053729077c4cbca0a3f96abd4c3e78 |
| institution | Kabale University |
| issn | 1471-2482 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj-art-46053729077c4cbca0a3f96abd4c3e782025-01-12T12:06:10ZengBMCBMC Surgery1471-24822025-01-012511710.1186/s12893-024-02709-4Navigating complex arterial reconstruction in living donor liver transplantation: the role of the splenic artery as a viable conduitHosam Hamed0Mohamed Elshobary1Tarek Salah2Ahmad M. Sultan3El-sayed Abou El-Magd4Ahmed M. Elsabbagh5Ahmed Shehta6Mohamed Abdulrazek7Waleed Elsarraf8Mohamed A. Elmorshedi9Mostafa Abdelkhalek10Usama Shiha11Hassan Magdy Abd El Razek12Mohamed Abdel Wahab13Liver Transplant Unit, Gastrointestinal Surgical Center (GISC), Surgery Department, Mansoura UniversityLiver Transplant Unit, Gastrointestinal Surgical Center (GISC), Surgery Department, Mansoura UniversityLiver Transplant Unit, Gastrointestinal Surgical Center (GISC), Surgery Department, Mansoura UniversityLiver Transplant Unit, Gastrointestinal Surgical Center (GISC), Surgery Department, Mansoura UniversityLiver Transplant Unit, Gastrointestinal Surgical Center (GISC), Surgery Department, Mansoura UniversityLiver Transplant Unit, Gastrointestinal Surgical Center (GISC), Surgery Department, Mansoura UniversityLiver Transplant Unit, Gastrointestinal Surgical Center (GISC), Surgery Department, Mansoura UniversityLiver Transplant Unit, Gastrointestinal Surgical Center (GISC), Surgery Department, Mansoura UniversityLiver Transplant Unit, Gastrointestinal Surgical Center (GISC), Anesthesia Department, Mansoura UniversityLiver Transplant Unit, Gastrointestinal Surgical Center (GISC), Anesthesia Department, Mansoura UniversityLiver Transplant Unit, Gastrointestinal Surgical Center (GISC), Anesthesia Department, Mansoura UniversityLiver Transplant Unit, Gastrointestinal Surgical Center (GISC), Radiology Department, Mansoura UniversityLiver Transplant Unit, Gastrointestinal Surgical Center (GISC), Radiology Department, Mansoura UniversityLiver Transplant Unit, Gastrointestinal Surgical Center (GISC), Surgery Department, Mansoura UniversityAbstract Background In living donor liver transplantation (LDLT), maintaining hepatic arterial flow is critical for graft survival. Alternative methods are required when the recipient’s hepatic artery is unsuitable due to extensive dissection or inadequate flow. This study evaluates the efficacy and safety of splenic artery transposition (SAT) for hepatic arterial reconstruction in LDLT. Methods This retrospective cohort study included 10 LDLT patients with hepatic arterial reconstruction by SAT to assess operative parameters, postoperative complications, mortality, and patency rate. Results The splenic artery was used because of arterial dissection (70%) or inadequate arterial blood flow. Operative time ranged from 640 to 1020 min, and no splenic infarction was observed. Post-operative complications were as follows; biliary leakage (10%), pancreatitis (10%), intraabdominal hemorrhage (10%), and arterial thrombosis (10%). Mortality in this cohort was 30%, one of them was due to thrombosis of the conduit and the other two died from sepsis-related complications. With a median follow-up of 43 months, this technique was associated with a 70% survival rate. Conclusion The splenic artery is a viable conduit for hepatic arterial reconstruction in LDLT, demonstrating an acceptable safety profile and complication rates. This approach is recommended in cases where the recipient’s hepatic artery is significantly compromised.https://doi.org/10.1186/s12893-024-02709-4Living donor liver transplantationHepatic arterySplenic arteryReconstruction |
| spellingShingle | Hosam Hamed Mohamed Elshobary Tarek Salah Ahmad M. Sultan El-sayed Abou El-Magd Ahmed M. Elsabbagh Ahmed Shehta Mohamed Abdulrazek Waleed Elsarraf Mohamed A. Elmorshedi Mostafa Abdelkhalek Usama Shiha Hassan Magdy Abd El Razek Mohamed Abdel Wahab Navigating complex arterial reconstruction in living donor liver transplantation: the role of the splenic artery as a viable conduit BMC Surgery Living donor liver transplantation Hepatic artery Splenic artery Reconstruction |
| title | Navigating complex arterial reconstruction in living donor liver transplantation: the role of the splenic artery as a viable conduit |
| title_full | Navigating complex arterial reconstruction in living donor liver transplantation: the role of the splenic artery as a viable conduit |
| title_fullStr | Navigating complex arterial reconstruction in living donor liver transplantation: the role of the splenic artery as a viable conduit |
| title_full_unstemmed | Navigating complex arterial reconstruction in living donor liver transplantation: the role of the splenic artery as a viable conduit |
| title_short | Navigating complex arterial reconstruction in living donor liver transplantation: the role of the splenic artery as a viable conduit |
| title_sort | navigating complex arterial reconstruction in living donor liver transplantation the role of the splenic artery as a viable conduit |
| topic | Living donor liver transplantation Hepatic artery Splenic artery Reconstruction |
| url | https://doi.org/10.1186/s12893-024-02709-4 |
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