Use of living donor liver grafts with double or triple arteries

BACKGROUND: Hepatic grafts used in living donor liver transplantation (LDLT) sometimes have two or more arteries, in which surgeons are required to perform complex arterial reconstruction. The aim of the current study was to demonstrate whether selecting living donor liver grafts with double or triple arteries yielded the same outcomes as grafts with a single artery. METHODS: We retrospectively investigated the outcomes of LDLT focusing on the numbers of arteries on grafts. Four hundred forty-six cases of LDLT performed between October 1996 and October 2012 were retrospectively analyzed. The cases were divided into the following three groups according to the number of arteries on a graft: the single (n=331), the double (n=108), and the triple (n=7) groups. RESULTS: Artery-related complications occurred in five cases in the single group, two cases in the double group, and no case in the triple group. Although the overall graft survival was comparable among the three groups, there was a tendency of worsened graft survival and increased incidence of anastomotic biliary stricture after liver transplantation in right hepatic grafts with double arteries. CONCLUSIONS: The use of grafts with double or triple arteries yielded favorable outcomes with minimum artery-related complications compared with grafts with a single artery. However, the use of right hepatic grafts with double arteries is discouraging in the current study.