Cryopreserved arterial grafts as a conduit in outflow reconstruction in living donor liver transplantation.
BACKGROUND
Few reports have addressed the use of cryopreserved arterial grafts (CAG) for anterior section drainage in right lobe living donor liver transplantation (RL LDLT), and the impact of atherosclerosis on patency rate (PR) is not well studied. Also, those reports have limited case numbers. The aim of the present study is to report the largest experience with CAG in outflow reconstruction in RL LDLT and the impact of atherosclerosis on its patency.


METHODS
During 2010 and 2011, 62 of 243 patients who underwent LDLT received outflow reconstruction with CAG for RL grafts. Atherosclerosis in CAG was classified into early, intermediate and advanced lesions according to the classification adopted by the American Heart Association: group 1 with grafts having no atherosclerosis or early lesions; and group 2 with grafts having intermediate and advanced lesions. Patency rates of CAG correlated with atherosclerotic change of CAG were retrospectively analyzed.


RESULTS
The study group comprised 65 CAGs with 1, 3 and 6 months PR of 86.2%, 84.6% and 75.2% respectively. Histopathological examination was successful in 53 CAGs. The 1, 3 and 6 months PR of group with no/early atherosclerosis were 86%, 83.7% and 76.7%, respectively, while for groups with intermediate/advanced lesions they were 90%. However, there was no significant difference between the two groups (P = 0.384).


CONCLUSIONS
Cryopreserved arterial grafts can be used for outflow reconstruction in RL LDLT with a good patency rate. Atherosclerosis appears to have minimal effect on CAG patency, yet further studies with larger cohorts are needed to support our results.
['Ali|Mahmoud Abdelwahab|MA|', 'Yong|Chee-Chien|CC|', 'Eng|Hock-Liew|HL|', 'Wang|Chih-Chi|CC|', 'Lin|Ting-Lung|TL|', 'Li|Wei-Feng|WF|', 'Wang|Shih-Ho|SH|', 'Lin|Chih-Che|CC|', 'Yap|Anthony|A|', 'Chen|Chao-Long|CL|']
D000328:Adult D000368:Aged D000714:Anastomosis, Surgical D001158:Arteries D015925:Cryopreservation D005260:Female D005500:Follow-Up Studies D006503:Hepatic Veins D006801:Humans D008099:Liver D016031:Liver Transplantation D019520:Living Donors D008297:Male D008875:Middle Aged D012189:Retrospective Studies D013997:Time Factors D014654:Vascular Patency D014656:Vascular Surgical Procedures
Cryopreservation Arterial grafts Outflow reconstruction Living donor liver transplantation Patency