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Case Reports in Medicine
Volume 2010, Article ID 584631, 3 pages
http://dx.doi.org/10.1155/2010/584631
Case Report

Direct Anastomosis of the Donor Hepatic Artery to the Supraceliac Aorta without Extension Graft during Adult Liver Transplant in the Era of Extended Criteria Donors: Report of a Case

1Department of Surgery, Division of Transplantation, University of Colorado Denver, Campus Box C-318, 1635 Aurora Court, Aurora, CO 80045, USA
2Department of Radiology, University of Colorado Denver, Aurora, CO, USA

Received 7 November 2009; Revised 19 March 2010; Accepted 18 April 2010

Academic Editor: Anne M. Larson

Copyright © 2010 Jeffrey Campsen 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

Arguably, one of the most challenging aspects of liver transplant surgery is the hepatic artery reconstruction. When the donor and recipient arteries are normal, this anastomosis can still be difficult. However, when the recipient artery has been dissected or is small other alternative reconstructions must be considered. Routinely, the donor surgery includes removing the iliac artery and vein specifically to aid in alternative reconstruction techniques. With the increase use of extended criteria donors (i.e., specifically age >55) the iliac vessel may be unusable because of atherosclerotic disease. This paper describes revisiting an alternative technique for hepatic artery reconstruction during cadaveric liver transplant when the recipient artery has been dissected and the iliac vessels were unusable secondary to arterial plaque from a 75 yo donor. Herein, we describe the successful anastomosis of the celiac artery with aortic patch from the donor directly to the supraceliac aorta of the adult recipient.