ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

End-to-Side Splenic to Hepatic Artery Reconstruction in Liver Transplant: A Case Series

N. Baker, L. Aviles-Ovalle, T. Baker, J. Campsen, R. Kim, G. Rofaiel

Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT

Meeting: 2022 American Transplant Congress

Abstract number: 1439

Keywords: Hepatic artery, Liver, Liver grafts, Liver transplantation

Topic: Clinical Science » Liver » 57 - Liver: Surgery Innovative Techniques*

Session Information

Session Name: Liver: Surgery Innovative Techniques*

Session Type: Poster Abstract

Date: Monday, June 6, 2022

Session Time: 7:00pm-8:00pm

 Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: Optimal hepatic artery (HA) blood flow post-liver transplantation (LT) is necessary for long-term allograft success. HA thrombosis (HAT) contributes to significant morbidity and mortality after LT. An aortic jump graft (infrarenal and supraceliac) is most commonly considered to optimize HA inflow in instances where the native HA is not adequate. We present a case series where the native splenic artery is used for HA reconstructed in an end-to-side anastomosis.

*Methods: In this case series, we report five liver transplantation cases where the native splenic artery was used for HA reconstruction. Standard LT was performed using a piggyback technique for caval reconstruction and end to end for portal vein. The common hepatic artery (CHA) was found to be unfit for reconstruction. Three cases were redo liver transplants, and in two cases intimal dissection of CHA was noted during hepatectomy. The splenic artery (SA) was then exposed and dissected free of its surrounding tissue. A clamp is placed in a side-biting fashion on the SA, an arteriotomy was performed, and an aortic punch expands the arteriotomy. The celiac trunk of the graft was anastomosed using a 6-0 Prolene. An end-to-side anastomosis using the donor celiac axis is fashioned to the arteriotomy of the SA. The donor splenic and left gastric arteries were ligated. The LT then proceeded in the standard fashion.

*Results: Doppler US on all patients was performed on day 1 and 3 postop as per institutional protocol. Excellent arterial waveforms were demonstrated. One PT required post-transplant splenectomy for significant splenic steal. One patient also required hepatic artery dilation without the need for stenting about 16 weeks following the transplant.

*Conclusions: This report presents a novel approach to HA reconstruction using an end-to-side anastomosis to the SA. The SA often has more than adequate length and diameter, allowing a tension free anastomosis with adequate flow for the liver graft. In conclusion, we present an acceptable technique for extra-anatomic HA reconstruction using SA inflow.

Table 1: Patient Demographics
Patient #1 Patient #2 Patient #3 Patient #4 Patient #5
Case Type Redo Liver Tx Intimal dissection Redo Liver Tx Redo Liver Tx
Intimal dissection
Age 58 32 42 61 35
BMI 32.39 23.56 22.04 34.56 27.04
Tx Indication ESLD ESLD EoTH ESLD second to NASH/EoTH ESLD second to EoTH
Diabetes No T1 No T2 T2
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

To cite this abstract in AMA style:

Baker N, Aviles-Ovalle L, Baker T, Campsen J, Kim R, Rofaiel G. End-to-Side Splenic to Hepatic Artery Reconstruction in Liver Transplant: A Case Series [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/end-to-side-splenic-to-hepatic-artery-reconstruction-in-liver-transplant-a-case-series/. Accessed May 30, 2025.

« Back to 2022 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences