DONOR ARTERIAL VARIATIONS IN LIVER-TRANSPLANTATION - MANAGEMENT AND OUTCOME OF 527 CONSECUTIVE GRAFTS

The impact of donor arterial variations and their management was inves tigated retrospectively in 527 consecutive allografts. Anomalous arter ies were found in 161 grafts (30.6 per cent). There was no significant difference in the overall incidence of arterial complications between grafts with normal (3.6 per cent) and abnormal (5.6 per cent) anatomy . However, there was a higher incidence of arterial complications in t ransplants requiring multiple arterial anastomoses (P=0.02), or anasto mosis of donor vessels to recipient aorta with (P=0.0003) or without ( P=0.04) an interposition graft for arterial reconstruction. The incide nce of biliary complications was similar in grafts with a normal (18.8 per cent) or anomalous (18.0 per cent) arterial supply. Anomalies of hepatic arterial anatomy occur in one-third of all livers and do not c ompromise graft outcome unless multiple anastomoses or direct anastomo sis to the recipient aorta are required for arterial reconstruction.