Immediate redo hepatic artery reconstruction in living donor liver transplantation

Background:in living donor liver transplant,vascular complications by compromising the blood flow to the graft can have significant and sometimes might lead to life-threatening consequences for the patient. aim: to evaluate the practice of immediate redo hepatic artery reconstruction in living donor liver transplant. methods: across sectional study (june 2003-august 2015) included recipients with hepatic artery complication who underwent living donor liver transplantation at chang gung memorial hospital,kaohsiung,taiwan. intraoperative complications necessitating immediate redo reconstruction of hepatic arterywere recorded. vascular patency was evaluated by intraoperative and postoperative doppler ultrasonography. immediate redo reconstruction was carried out when either arterial wall problem or low flow or ri less than 0.55. late redo reconstruction (> 24 hours) was carried out to patients developed hat postoperatively. the data was analyzed by spss version 21. p value less than 0.05 was regarded as significant. results: a59 recipients developed hepatic artery complication,and underwent redo reconstruction with incidence of 6.6%. immediate redo reconstruction was performed in 86.4%,and 13.6% underwent late redo reconstruction (>24 hours). minimal discrepancy was encountered in 71.2%,and there was significant correlation between discrepancy and ri,(p=0.048). ri <0.55 was seen in 25.4%. there was significant difference in the outcome between the groups of patient managed by early versus late ha redo reconstruction,(p=0.031). conclusion: preliminary results show that immediate redo ha reconstruction preserving blood flow,maintaining perfusion and preventing post-transplant graft loss.