Effect of Initial Hepatic Arterial Followed by Portal Reperfusion on Outcomes After Liver Transplantation.
1Department of Surgery, University of Virginia Medical Center, Charlottesville, VA
2University of Virginia School of Medicine, Charlottesville, VA
Meeting: 2017 American Transplant Congress
Abstract number: B198
Keywords: Graft survival, Hepatic artery, Liver transplantation, Surgical complications
Session Information
Session Name: Poster Session B: Liver Retransplantation and Other Complications
Session Type: Poster Session
Date: Sunday, April 30, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Background: While initial portal reperfusion (PV) of a liver allograft is nearly standardized, limited data suggests initial hepatic arterial reperfusion (HA) may improve hemodynamics and posttransplant outcomes.
Methods: We retrospectively reviewed consecutive, adult, primary orthotopic liver transplants (OLT) performed between January 2011 and February 2015 at our center. Demographics and outcomes of liver recipients with initial HA reperfusion were compared to those with initial PV reperfusion. Results: Of 204 recipients, 53 (26%) were initially perfused from the HA and 151(74%) were initially perfused from portal vein. These two groups did not differ in terms of age, gender, MELD score, type of HA, PV, caval or biliary reconstruction. When comparing recipients with HA vs. PV initial reperfusion at 3 month and 1 year, there was no difference in the incidence of acute rejection (1.9% vs. 7.9% p=ns, and 7.5% vs. 10.6%, p=ns), hepatic artery thrombosis (1.9% vs. 4.0%, p=ns and 1.9% vs. 7.3%, p=ns), biliary leakage (7.5% vs. 4.0%, p=ns; 9.4 vs. 6.6, p=ns), biliary strictures (7.5% vs. 5.3%; p=ns, 11.3% vs. 7.9%, p=ns)or portal and hepatic venous thrombosis/stenosis (5.7% vs. 5.3%, p=ns; 7.5% vs. 7.9%, p=ns). Furthermore, recipient with HA and PV initial reperfusion were both hospitalized for a median of 8.5 days (interquartile range [IQR], 6.5 to 15.5 vs. 7.0 to 14.0 days, respectively) and were both in ICU for a median of 3 days (IQR: 2 to 7 vs. 2 to 4 days, respectively). HA initial reperfusion was associated with significantly less intraoperative PRBC transfusion (median, 11.9 units; IQR, 11.1 to 13.1 units vs. 15.5 units; IQR, 12.9 to 17.9 units, p<0.001). The two groups did not differ in terms of patient and graft survival.
Conclusion: Initial reperfusion of liver allografts with arterial, rather than portal, blood has theoretical benefits to hemodynamic stability, did not have deleterious effects on outcomes, and resulted in less blood utilization.
CITATION INFORMATION: Shahbazov R, Azari F, Alejo J, Talanian M, Fox M, Kennedy K, Kessel S, Nickkholgh A, Maluf D, Pelletier S. Effect of Initial Hepatic Arterial Followed by Portal Reperfusion on Outcomes After Liver Transplantation. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Shahbazov R, Azari F, Alejo J, Talanian M, Fox M, Kennedy K, Kessel S, Nickkholgh A, Maluf D, Pelletier S. Effect of Initial Hepatic Arterial Followed by Portal Reperfusion on Outcomes After Liver Transplantation. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/effect-of-initial-hepatic-arterial-followed-by-portal-reperfusion-on-outcomes-after-liver-transplantation/. Accessed May 16, 2025.« Back to 2017 American Transplant Congress