Liver Transplantation Utilizing Mixed Biologic and Synthetic Arterial Conduits.

Marcio F Chedid,Ariane N Backes,Aljamir D Chedid,Matheus J Reis,Tomaz J M Grezzana-Filho,Luiz Pedro P Hendges,Mario R Alvares-Da-Silva,Ian Leipnitz,Cleber Dario P Kruel,Cleber R P Kruel

doi:10.1155/2016/9245079

Marcio F Chedid, Ariane N Backes + Show 8 more

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https://doi.org/10.1155/2016/9245079

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Abstract

Arterial conduits are necessary in nearly 5% of all liver transplants and are usually constructed utilizing segments of donor iliac artery. However, available segments of donor iliac artery may not be lengthy enough or may not possess enough quality to enable its inclusion in the conduit. Although there are few reports of arterial conduits constructed solely utilizing prosthetic material, no previous reports of conduits composed of a segment of donor iliac artery and prosthetic material (mixed biologic and synthetic arterial conduits) were found in the medial literature to date. Two cases reporting successful outcomes after creation of mixed biologic and prosthetic arterial conduits are outlined in this report. Reason for creation of conduits was complete intimal dissection of the recipient's hepatic artery in both cases. In both cases, available segments of donor iliac artery were not lengthy enough to bridge infrarenal aorta to porta hepatis. Both patients have patent conduits and normally functioning liver allografts, respectively, at 4 and 31 months after transplant. Mixed biologic and synthetic arterial conduits constitute a viable technical option and may offer potential advantages over fully prosthetic arterial conduits.

Highlights

A segment of donor iliac artery usually is utilized as the arterial conduit, bridging recipient’s infrarenal aorta to hepatic artery of the liver allograft (HAA) [3, 4]
Distal end of PFTE graft was sewn to Hepatic Artery of the Allograft (HAA) utilizing running 7 mm polypropylene sutures (Figure 1(c))
Potential complications related to arterial conduits include an increased risk of hepatic artery thrombosis

Summary

Introduction

A segment of donor iliac artery usually is utilized as the arterial conduit, bridging recipient’s infrarenal aorta to hepatic artery of the liver allograft (HAA) [3, 4]. Available segments of donor iliac artery may not be lengthy enough or may not possess enough quality to enable its inclusion in the arterial conduit. There are few reports of arterial conduits constructed solely utilizing prosthetic material [4, 5], no previous report of conduits composed of a segment of donor iliac artery and prosthetic material (mixed biologic and synthetic arterial conduits, MAC) has been found in the literature. The first report of successful utilization of MAC in liver transplantation is outlined in this report

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