A Technique of Hepatic Artery Anastomosis in Living Donor Liver Transplantation: Back-wall First Technique

Abstract

Microvascular technique of placing three stay sutures at 120° intervals around the circumference of the arteries to be anastomosed is limited in its usefulness in LDLT as hepatic artery (HA) is shorter, smaller, and thin-walled hindering the surgeon's ability to rotate it with the vascular clamps in situ whilst completing the anastomosis. Our technique of HA reconstruction overcomes this problem by placing two adjacent sutures at 6 O'clock in the posterior wall after preparing and positioning donor's and recipient's HAs (A).