1. Successful Transplant of a Nonagenarian Liver Graft With Fully Replaced Right Hepatic Artery Reconstruction.
- Author
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Ghinolfi D, Gianardi D, Cirillo G, De Simone P, Pezzati D, Arenga G, Battaglia V, and Filipponi F
- Subjects
- Age Factors, Aged, 80 and over, Carcinoma, Hepatocellular pathology, Carcinoma, Hepatocellular virology, Computed Tomography Angiography, Female, Hepatic Artery diagnostic imaging, Hepatitis B complications, Humans, Liver Neoplasms pathology, Liver Neoplasms virology, Middle Aged, Neoplasm Staging, Treatment Outcome, Ultrasonography, Doppler, Carcinoma, Hepatocellular surgery, Donor Selection, Hepatic Artery surgery, Liver Neoplasms surgery, Liver Transplantation methods, Plastic Surgery Procedures methods, Tissue Donors, Vascular Surgical Procedures methods
- Abstract
Organ shortage and increasing donor age in liver transplant are stimulating transplant centers to accept otherwise discarded grafts due to donor age or vascular abnormalities; nevertheless, the use of nonagenarian donor grafts is uncommon because advanced age is associated with a higher risk of ischemic-type biliary lesions and worse long-term graft survival. We herein report the case of a 90-year-old donor with fully replaced right hepatic artery. After back-table vascular assessment, the donor right hepatic artery was anastomosed end-to-end with the gastroduodenal artery with 2 polypropylene 8/0 running sutures. Even if the back-table reconstruction of a replaced right hepatic artery is not associated with an enhanced risk of posttransplant vascular complications, vascular abnormalities might discourage the use of otherwise acceptable elderly grafts. The present case underscores that elderly liver grafts should not be discarded per se even in the presence of vascular variants.
- Published
- 2019
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