Morphometric analysis of five interpositional arterial autografts options for living related liver transplantation in adults

Abstract

In living donor liver transplantation, the graft presentsonly a segmental artery, which usually has small caliber and extension. Therefore, disproportion may occur between graft’s artery and the recipient‘s hepatic artery caliber, as well the distance between them may be too wide. In these cases, an interpositional vascular autograft can be utilized in order to make the procedure easier, avoiding surgical complications. Aim: We compared the inferior mesenteric artery (IMA), the splenic artery (SA), the inferiorepigastric artery (IEA), the descending branch of the lateral circumflex femoral artery (LCFA) and the proper hepatic artery (PHA) as options of interpositional autograft in living related liver transplantation. Method: 16 fresh cadavers from both genders were dissected to obtain the referred vessels from each body. The analyzed measures were proximal and distal diameter and length. The proximal diameter of RHA and the distal diameter of SA, IMA, IEA and the descending branch of the LCFA were compared to the distal diameter of the RHA. The proximal and distal diameters of the SA, IEA and the descending branch of the LCFA were compared to study caliber gain of each artery. Results: All arteries, except the IMA, showed statistical significant difference in relation to the RHA in terms of diameter. Regarding caliber gain, the arteries demonstrated statistical significant difference. All arteries, except PHA, presented length equal to 3 cm. Conclusion: The IMA demonstratedthe best compatibility with the RHA in terms of diameter and has shown sufficient length to be employed as interpositional graft. The PHA, the SA, the IEA and the descending branch of the LCFA presented statistically significant different diameters when compared to the RHA. Among these vessels, only the PHA did not show sufficient mean length.