TY - CHAP M1 - Book, Section TI - Arterial Reconstruction A1 - Cano Busnelli, Virginia M. A1 - Huespe, Pablo E. A1 - de Santibañes, Martin A2 - Molmenti, Ernesto Pompeo A2 - Santibañes, Martin de A2 - Santibañes, Eduardo de PY - 2021 T2 - Liver Transplantation: Operative Techniques and Medical Management AB - A proper reconstruction of afferent and efferent vessels is a sine qua non condition for successful liver transplantation. Reduced blood inflow due to technical problems often lead to early postoperative graft loss or long-term complications and need for retransplantation.1 Vascular complications ranges from 2% to 25% in most publications.2 Arterial complications prevail, and thrombosis is the most common. According to a systematic review by Bekker et al.,3 the incidence of early hepatic artery thrombosis (eHAT) was 8.3% in children and 2.9% in adults (p <0.001) with an overall retransplantation rate of 61.9% in children and 50% in adults. The overall mortality rate of patients with eHAT was 33.3% (range: 0% to 80%). Mortality in adults (34.3%) was higher than in children (25%, p <0.03). Thus, the determination of the preoperative vascular status of the recipient is mandatory, as well as in the donor organ. Given that the vascular status of the donor organ is not always possible to assess preoperatively, a very careful harvest of the organ is necessary for optimal transplant revascularization due to the multitude of arterial variants and pathologic changes in the afferent liver vasculature. SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/03/29 UR - accesssurgery.mhmedical.com/content.aspx?aid=1180112767 ER -