An alternative method of arterial reconstruction after hepatic arterial thrombosis following living-related liver transplantation

Background. Hepatic artery thrombosis (HAT) remains an important cause of g raft loss after liver transplantation. Emergency rearterialization methods are limited in cases of living-related liver transplantation in which the g raft hepatic artery is thin and short. Case. A 19-year-old woman who underwent living-related liver transplantatio n for biliary atresia developed HAT on the 4th postoperative day. During th e emergency laparotomy the recipient hepatic artery was found to be too sho rt to anastomose, so the recipient's right gastroepiploic artery was anasto mosed to the graft hepatic artery. The patient is now alive and well 6 mont hs after reoperation, and she has experienced no further episode of HAT. Conclusion. The right gastroepiploic artery can be used easily and safely f or hepatic graft revascularization without causing ischemia of the stomach. An additional skin incision is not required, and the artery is long enough to anastomose to the graft artery directly. The method of hepatic graft re arterialization described here is an important option for patients who unde rgo living-related or split liver transplantation.