*Purpose: Impact of level and laterality of the recipient hepatic artery used for arterial reconstruction in living donor liver transplantation on the outcomes of biliary reconstruction has not yet studied well.

*Methods: This is a retrospective analysis of liver transplantation cases in our institute in the period between January 2010 and December 2019. We excluded those who had hepaticojejunostomy for biliary reconstruction and those who had more than one arterial anastomoses for arterial reconstruction. We identified and compared 2 groups based on the level and laterality of recipient hepatic artery used for arterial reconstruction (Group A: Right Hepatic Artery, Proper Hepatic Artery & Group B: Left Hepatic Artery, Right Anterior Artery, Right Posterior Artery). Typically less dissection occurs around the bile duct in Group B.

*Results: 613 cases were studied, Group A included 420 and Group B included 193 cases. Median age for group A was 51 years versus 52 year for group B (P=0.708). 85.6 % were male in group A versus 85% in group B (P = 0.860). Postoperative biliary leak (5.4% in group A vs. 13.9 % in the group B, P = 0.0001). Postoperative biliary stricture (11.1% in group A vs. 12.8 % in the group B, P = 0.544).

*Conclusions: Using recipient right hepatic artery or proper hepatic artery for arterial reconstruction in living donor liver transplantation did not negatively impact the biliary reconstruction outcomes. Indeed, it was associated with less bile leak. This assures surgeons to use the most suitable recipient artery for arterial reconstruction regardless the side or the level of the artery. This should be repeated in multicenter study.

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