Microvascular hepatic artery anastomosis in pediatric segmental liver transplantation: microscope vs loupe. Academic Article uri icon

Overview

abstract

  • Use of operative microscopy (OM) has dramatically reduced the incidence of hepatic artery thrombosis (HAT) in children undergoing segmental liver transplantation. We used OM (12-16x) in our early experience. We changed to high power loupe magnification (6x) after 14 cases. We examined our experience with microvascular hepatic artery reconstruction in 28 consecutive children (< 18 years) who underwent living donor (LDLT) or split liver transplantation (SLT). Reconstructions were done with interrupted, end-to-end anastomoses with 8-0 polypropylene using microvascular techniques. Group 1 consisted of 14 children who underwent LDLT employing OM for the hepatic artery anastomosis. Group 2 consisted of the subsequent 14 children (11 LDLT, 3 SLT) in whom 6x loupe optics were used for the arterial anastomosis. Grafts included 25 left lateral segments, 2 left lobes, and 1 right lobe. Recipients' median age was 1.0 years (range 3 months to 17 years). The mean follow-up time was 27.1 months. There were no cases of HAT. Variables of age, sex, graft type, number of Doppler ultrasound exams (DUS), and biliary complications were similar between groups. Microvascular hepatic artery reconstruction in children with 6x loupe magnification can yield results as good as operative microscopy.

publication date

  • November 3, 2004

Research

keywords

  • Anastomosis, Surgical
  • Hepatic Artery
  • Lenses
  • Liver Transplantation
  • Microscopy

Identity

Scopus Document Identifier

  • 12144266829

Digital Object Identifier (DOI)

  • 10.1007/s00147-004-0782-8

PubMed ID

  • 15592715

Additional Document Info

volume

  • 17

issue

  • 10