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Korean J Transplant 2021; 35(3): 183-188

Published online September 30, 2021

https://doi.org/10.4285/kjt.20.0059

© The Korean Society for Transplantation

Hepatic artery reconstruction using interposition of autologous saphenous vein conduit for living donor liver transplantation: a case report

Deok-Bog Moon , Shin Hwang , Dong-Hwan Jung , Chul-Soo Ahn , Gil-Chun Park , Tae-Yong Ha , Gi-Won Song , Young-In Yoon , Sung-Gyu Lee

Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Correspondence to: Shin Hwang
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpagu, Seoul 05505, Korea
Tel: +82-2-3010-3930
Fax: +82-2-3010-6701
E-mail: shwang@amc.seoul.kr

Received: December 22, 2020; Revised: March 7, 2021; Accepted: March 31, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We have preferentially used the right gastroepiploic artery (RGEA) as an alternative for the recipient hepatic artery (HA) inflow during living donor liver transplantation (LDLT), but it was not always available. We herein present a case of adult LDLT with HA reconstruction using a greater saphenous vein (GSV) conduit because of the absence of the RGEA due to prior subtotal gastrectomy. A 55-year-old male patient diagnosed with hepatitis B virus-associated liver cirrhosis and secondary biliary cirrhosis underwent LDLT using a modified right liver graft. The upper abdominal cavity was heavily adhered due to prior abdominal surgeries, thus we had to sacrifice the common bile duct and the right HA completely. A 6-cm-long GSV segment was harvested from the left ankle and interposed between the recipient gastroduodenal artery and the graft HA. The patient recovered from LDLT and HA complications did not occur. However, 8 years after LDLT, chronic rejection occurred, thus repeated deceased donor liver transplantation was performed. This patient has been doing well for 2 years after retransplantation. In conclusion, we suggest that interposition of an autologous GSV conduit can be an alternative for establishing HA inflow in LDLT when other inflow source is not available.

Keywords: Liver transplantation, Hepatic artery thrombosis, Vascular interposition, Living donor, Saphenous vein, Case report

HIGHLIGHTS
  • We present a case of adult living donor liver transplantation with hepatic artery reconstruction using a greater saphenous vein conduit.

  • Interposition of an autologous greater saphenous vein conduit can be an alternative for establishing hepatic artery inflow in living donor liver transplantation when other inflow source is not available.