Microvascular Anastomosis of Hepatic Artery in Children Undergoing Liver Transplantation

소아 간이식에서 간동맥의 미세혈관 문합술

  • Jin, Ung Sik (Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine) ;
  • Chang, Hak (Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine) ;
  • Minn, Kyung Won (Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine) ;
  • Yi, Nam Joon (Department of Surgery, Seoul National University College of Medicine) ;
  • Suh, Kyung Suk (Department of Surgery, Seoul National University College of Medicine)
  • 진웅식 (서울대학교 의과대학 성형외과학교실) ;
  • 장학 (서울대학교 의과대학 성형외과학교실) ;
  • 민경원 (서울대학교 의과대학 성형외과학교실) ;
  • 이남준 (서울대학교 의과대학 외과학교실) ;
  • 서경석 (서울대학교 의과대학 외과학교실)
  • Received : 2006.04.19
  • Published : 2006.07.10

Abstract

Purpose: The anastomosis of hepatic artery to recipient vessel has a major role in a liver transplantation, so its occlusion is the most important cause of failure of liver transplantations. We made the study to reveal the peculiarities in pediatric liver transplantations compared with adult cases. Methods: From January 1999 to September 2005, we performed 99 cases of pediatric liver transplantation. The mean age at operation was 4.17 years of age. The hepatic vein and portal vein are anastomosed by the general surgeons and then the hepatic artery is anastomosed by the plastic surgeons. The Doppler ultrasonography and computed tomography were used for postoperative checkup for hepatic artery patency. Results: There were no immediate complications, but hepatic arterial occlusion was developed in 3 cases (2.8%). In pediatric patients, the anastomosis of hepatic artery is more difficult than adults because of the rapid respiratory and pulse rate, the small vascular diameter, and the large gap of diameter difference between the recipient and the donor vessels. Conclusion: We could confirm that pediatric liver transplantations are relatively safe but long learning curve was needed.

Keywords

References

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