Ann Liver Transplant.  2024 May;4(1):30-36. 10.52604/alt.24.0002.

Outcomes of living donor liver transplantation using graft with multiple hepatic arteries on the graft: Propensity score-matched analysis

• Kang M
• Koh HH
• Kim DG
• Yim SH
• Choi MC
• Min EK
• Lee JG
• Joo DJ
• Kim MS

• KMID: 2560939
• DOI: http://doi.org/10.52604/alt.24.0002

Abstract

Background
This study aims to analyze the outcomes of living donor liver transplantation (LDLT) using grafts with multiple hepatic arteries (HAs), compared to those with a single HA.
Methods
A retrospective analysis was conducted on 1,059 LDLT patients from July 2005 to December 2022 at Severance Hospital, South Korea. Patients were categorized into multiple-HA and single-HA groups. Propensity score matching was employed to balance baseline characteristics, with primary outcomes being graft survival and secondary outcomes including HA, biliary, and total vascular complications.
Results
The study included 27 patients in the multiple-HA group and 925 in the single-HA group before matching. After propensity score matching, no significant difference in 5-year graft survival rates was observed between the groups (60.4% for multiple-HA vs. 72.8% for single-HA, p=0.172). However, the multiple-HA group exhibited a higher incidence of bile duct complications (80.0% vs. 48.3%, p=0.038). Multivariable Cox regression analysis did not find multiple HAs to be a significant predictor of graft loss but confirmed their association with increased bile duct complications.
Conclusion
LDLT using grafts with multiple HAs does not adversely affect overall graft survival compared to single-HA grafts. Nevertheless, the increased risk of bile duct complications associated with multiple HAs necessitates careful surgical planning and postoperative management to mitigate this risk.

Keyword

Living donors; Liver transplantation; Hepatic artery

Figure

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  Figure 1 Study flow. HA, hepatic artery; LDLT, living donor liver transplantation; PSM, propensity score matching.

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  Figure 2 Kaplan-Meier curve analyses comparing outcomes in matched population. (A) Graft survival, (B) hepatic artery (HA) complication, (C) total vascular complication, (D) bile duct complication. LT, liver transplantation.

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