Anatomical variations of the hepatic artery in liver grafts from brain-dead donors

Abstract

Introduction: The anatomical variations of the hepatic artery are a critical consideration in liver transplantation, impacting both surgical planning and postoperative outcomes. This study aimed to identify and classify hepatic artery variations in liver grafts procured from brain-dead donors at Viet Duc Hospital and to evaluate their implications for transplantation.

Patients and Methods: Data were collected retrospectively from 2011 to 2016 and prospectively from 2017 to 2020, covering 53 liver grafts obtained from brain-dead donors.

Results: Anatomical variants were categorized according to Hiatt’s classification and additional atypical patterns, with Type 1 (67.9%) being the most common, followed by Type 2 (13.2%) and Type 3 (7.6%) variants were observed. noteworthy typical variants included right hepatic arteries originating from the gastroduodenal artery. While 15 of 17 anatomical variations were detected intraoperatively, two were only identified during back-table preparation. Reconstruction was required in 7.5% of cases, primarily involving the right hepatic artery. Post-transplantation, hepatic artery complications were rare and not significantly associated with anatomical variations.

Conclusions: The findings emphasize the importance of meticulous dissection and preoperative imaging to accurately map hepatic arterial anatomy and to avoid intraoperative complications. Awareness and careful management of hepatic artery variations can contribute to improved graft outcomes and reduce the risk of arterial complications post-transplantation.

Keywords: liver transplantation, hepatic artery, brain death.

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