Microvascular Anastomosis of Hepatic Artery in Children Undergoing Liver Transplantation.

Jin, Ung Sik; Chang, Hak; Minn, Kyung Won; Yi, Nam Joon; Suh, Kyung Suk

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2006;33(4):454-457.
Published online July 1, 2006.

Microvascular Anastomosis of Hepatic Artery in Children Undergoing Liver Transplantation.

Ung Sik Jin, Hak Chang, Kyung Won Minn, Nam Joon Yi, Kyung Suk Suh

¹Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea. hchang@snu.ac.kr
²Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
The anastomosis of hepatic artery to recipient vessel has a major role in a liver transplantation, so its occlusion is the most important cause of failure of liver transplantations. We made the study to reveal the peculiarities in pediatric liver transplantations compared with adult cases. METHODS: From January 1999 to September 2005, we performed 99 cases of pediatric liver transplantation. The mean age at operation was 4.17 years of age. The hepatic vein and portal vein are anastomosed by the general surgeons and then the hepatic artery is anastomosed by the plastic surgeons. The Doppler ultrasonography and computed tomography were used for postoperative checkup for hepatic artery patency.
RESULTS
There were no immediate complications, but hepatic arterial occlusion was developed in 3 cases (2.8%). In pediatric patients, the anastomosis of hepatic artery is more difficult than adults because of the rapid respiratory and pulse rate, the small vascular diameter, and the large gap of diameter difference between the recipient and the donor vessels.
CONCLUSION
We could confirm that pediatric liver transplantations are relatively safe but long learning curve was needed.

Keywords: Pediatric liver transplantation; Hepatic artery