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Case Reports in Hepatology
Volume 2014 (2014), Article ID 616251, 3 pages
http://dx.doi.org/10.1155/2014/616251
Case Report

Right Gastroepiploic Artery as an Alternative for Arterial Reconstruction in Living Donor Liver Transplantation

1Hepatobiliary Surgery Unit, Serviço de Cirurgia Hepato-Biliar, Bonsucesso Federal Hospital-Health Ministry, Avenida Londres 616, Predio 3/2° Andar, 21041-030 Rio de Janeiro, RJ, Brazil
2Transplantation Unit, São Francisco Hospital-Rio de Janeiro State Health Secretary, Rua Conde de Bonfim 1033, 20530-190 Rio de Janeiro, RJ, Brazil
3General Surgery Department, Ipanema Federal Hospital-Health Ministry, Rua Antônio Parreiras 67/69, 22411-020 Rio de Janeiro, RJ, Brazil

Received 19 August 2014; Accepted 28 October 2014; Published 16 November 2014

Academic Editor: Melanie Deutsch

Copyright © 2014 Klaus Steinbrück et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. An adequate blood flow is directly related to graft survival in living donor liver transplantation. However, in some cases, unfavorable conditions prevent the use of the hepatic artery for arterial reconstruction. Herein, we report a case in which the recipient right gastroepiploic artery was used as an option for arterial reconstruction in adult-to-adult living donor liver transplantation. Case Report. A 62-year-old woman, with cirrhosis due to hepatitis B associated with hepatocellular carcinoma, was submitted to living donor liver transplantation. During surgery, thrombosis of the hepatic artery with intimal dissection until the celiac trunk was observed, which precluded its use in arterial reconstruction. We decided to use the right gastroepiploic artery for arterial revascularization of the liver graft. Despite the discrepancy in size between donor hepatic artery and recipient right gastroepiploic artery, anastomosis was performed successfully. Conclusions. The use of the right gastroepiploic artery as an alternative for arterial revascularization of the liver graft in living donor liver transplantation should always be considered when the hepatic artery of the recipient cannot be used. For performing this type of procedure, familiarity with microsurgical techniques by the surgical team is necessary.