Original Works: Case ReportsLiverUtilization of the Iliac Artery as Inflow in the Morbidly Obese During Orthotopic Liver Transplantation: A Case Report

- The iliac artery is a suitable conduit alternative in orthotopic liver transplants.
- Nonalcoholic steatohepatitis is a rising cause of end-stage liver disease.
- Nonalcoholic steatohepatitis is associated with significant cardiovascular comorbidity and unique atherogenic profiles.
- We describe utilization of the iliac artery as an inflow conduit in a morbidly obese patient undergoing orthotopic liver transplant.

Arterial conduits are a well-recognized technique used in liver transplantation to achieve allograft arterial inflow when conventional hepatic arterial inflow is compromised. Indications for ectopic inflow include native arterial disease at the time of initial transplantation, as well as reconstruction in the setting of thrombotic complications. Although supraceliac or infrarenal aortic reconstructions are preferred approaches, the right common iliac artery represents a viable alternative. We present the case of a morbidly obese patient with occlusive atheromatous plaque at the celiac origin not amenable to preoperative angioplasty who underwent reconstruction with a donor iliac artery conduit to the recipient right common iliac artery. His hepatic arterial inflow remained patent postoperatively with no thrombotic or hemorrhagic complications.