In-hospital and follow-up outcomes of patients undergoing orthotopic liver transplantation after hepatic artery reconstruction with an iliac interposition graft

Introduction: This study was to explore the indications, surgical method, and postoperative treatment of orthotopic liver transplantation (OLT) after hepatic artery (HA) reconstruction with an iliac interposition graft. Methods: This study analyzed in-hospital and follow-up outcomes of 34 Chinese patients: 17 who received conventional OLT (“non-bypass” group) and 17 who received OLT with hepatic artery reconstruction by iliac interposition bypass (“bypass” group). Complications were tracked using findings from clinical presentation, liver function, and HA ultrasound. Results: Compared to the non-bypass group, the bypass group had a longer average surgery time (48.47±11.86 min vs. 82.29±22.00 min, respectively; P < 0.01) and more blood loss (4,841.18±1,268.39 mL vs. 7,047.06±976.04 mL; P < 0.01). The postsurgical hepatic function of both groups quickly recovered and, by 10 days, there was no significant difference in the HA peak blood flow velocity between groups. The bypass patients were followed for an average of 45.2 months (range: 20-56 months), with no arterial-related complications (e.g., artery stenosis or arterial thrombosis) or fatalities. Conclusions: Iliac arterial interpositional graft is an effective and reliable method of HA reconstruction in OLT, when the use of the HA is not possible.