P487 Aims: In case of anomal hepatic arterial inflow, it can be necessary to perform revascularization of the liver allograft by iliac arterial interposizional graft. Methods: We analysed retrospectively 613 liver transplant in a 16-year period. The hepatic artery (HA) graft group (n=101) consisted of patients with arterial inflow based on recipient infrarenal aorta using donor iliac artery graft tunnelled through the transverse mesocolon. The control group (n=512) consisted of patients who underwent liver transplantation (OLT) with routine HA reconstruction. Results: Male/female ratio, donor age, indication for transplantation, the mean duration of OLT, incidence of primary graft non function, duration of follow-up, length of hospital stay were similar in the control group and HA graft group. In case of retransplantation, arterial conduit with iliac graft was adopted more frequently instead of conventional arterial anastomosis (24.8% vs. 9%, p=<0.0001). The 1-, 3- and 5-year overall survival was 85.41%, 79.42% and 76.57% in the control group and 76.21%, 73.43% and 73.43% in the HA graft group, respectively (p=ns). The 1-, 3- and 5-year graft survival was 81.51%, 73.66% and 69.22% in the control group and 71.17%, 62.50%, 53.42% in the HA graft group, respectively (p=0.01). In case of retransplantation, the 1-, 3- and 5-year overall survival was 57.81%, 53.95%, 41.96% in the control group and 60%, 51.95%, 49.85% in the HA graft group, respectively (p=ns); the 1-, 3- and 5-year graft survival was 57.52%, 53.68% and 41.75% in the control group and 56%, 50.4%, 40.3% in the HA graft group, respectively (p=ns). Hepatic artery thrombosis (HAT) rate is 21.8% vs. 8.6% (p <0.0001) in HA graft group and control group, respectively. The only factor independently predictive of HAT resulted the donor age> 50 year-old (p<0.0001, RR=1.04, 95% confidence interval (CI): 1.02-1.05). Furthermore, arterial conduit was found to be independent predictor of early HAT (p=0.001, RR=3.13, 95% CI: 1.57-6.21). Retransplant procedure, donor age and arterial iliac conduit were found to be a significant risk factors for late HAT, at univariate analysis. At multivariate analysis, donor age> 50 year-old resulted the only factor independently associated with late HAT (p<0.0001, RR=1.05, 95% CI: 1.02-1.07). Conclusions: Iliac arterial interpositional graft is an alternative solution for arterial revascularization of liver allograft in case of retransplantation when the use of hepatic artery is not possible. In case of primary transplantation, is better not to perform arterial conduit, for poor graft survival and high incidence of HAT, especially in case of liver donor aged over 50 year-old; in particular, when the native hepatic artery is too little, the application of microsurgical techniques is preferable.