Emerging Perspectives in TransplantationLiver transplantationSingle-Center Experience of Consecutive 522 Cases of Hepatic Artery Anastomosis in Living-Donor Liver Transplantation

•We examined risk factors of hepatic artery complication after living-donor liver transplantation.•Preoperative low hemoglobin level with large amount of blood product transfusion may indicate a risk of hepatic arterial thrombosis.•A small-sized hepatic artery was associated with an increased risk of hepatic artery stenosis.

ObjectiveThe aim of this study was to clarify risk factors and outcome of hepatic arterial complication after living-donor liver transplantations (LDLT).MethodsFrom 2004 to 2010, 522 consecutive LDLTs were performed. We used univariate and multivariate analysis to identify the risk factor on a retrospective basis, and then analysis was performed for adult cases. Hepatic arterial complication included thrombosis, stenosis, and pseudoaneurysm.ResultsThe arterial complication rate was 4.79% (25 cases). Each complication was 9 thromboses, 14 stenoses, and 2 pseudoaneurysms. Preoperative hemoglobin was significantly associated with thrombosis (P = .021), and arterial size with stenosis (P = .037). We could not find any association between arterial complications and biliary stricture. However, the outcome of biliary stricture treatment was associated with arterial stenosis. Of 9 cases with thrombosis, 7 patients underwent rearterialization and 2 were treated with low-molecular-weight heparin (LMWH). Of 14 stenosis cases, 2 patients were treated with the use of balloon dilatation, 10 patients were observed under LMWH, and 2 patients underwent retransplantation. In cases of pseudoaneurysm, 1 patient underwent revision of the aneurysm and the other was observed.ConclusionsIn our cohort, preoperative low hemoglobin level was a risk factor for thrombosis and artery size a risk factor for stenosis.