USE OF INFRARENAL CONDUITS FOR ARTERIAL REVASCULARIZATION IN ORTHOTOPIC LIVER-TRANSPLANTATION

Arterial conduits that use donor iliac arteries represent a reliable t echnique for graft revascularization in orthotopic liver transplantati on. We reviewed 757 consecutive liver transplantations performed betwe en 1989 and 1995 for acute or chronic liver disease in adults and chil dren. Of these, 218 patients received arterial conduits that used dono r iliac arteries. The incidence of hepatic artery thrombosis (HAT) for conduits was 4.1% (9 of 218 patients) compared with 4% (22 of 539 pat ients) for direct arterial anastomosis. Patients in the arterial condu it group included 66% (99 of 159) of the children younger than 5 years of age, 75% (67 of 89) of all patients who underwent retransplantatio n, and, in particular, 25 patients regrafted for HAT. Arterial conduit s provide an effective and reliable method of revascularization in pat ients at higher risk of arterial thrombosis. The actuarial 3-year pate ncy rate for conduits is 95% and the incidence of HAT is similar to th at in standard arterial anastomoses. Copyright (C) 1998 by the America n Association for the Study of Liver Diseases.