Comparison of Supraceliac and Infrarenal Aortic Conduits in Liver Transplantation: Is There a Difference in Patency and Postoperative Renal Dysfunction? Journal Article

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Authors: Livingston, D; Lee, DD; Croome, S; Burcin Taner, C; Croome, KP
Article Title: Comparison of Supraceliac and Infrarenal Aortic Conduits in Liver Transplantation: Is There a Difference in Patency and Postoperative Renal Dysfunction?
Abstract: Aorto-hepatic conduits can provide arterial inflow for liver transplants in cases where the native hepatic artery is unsuitable for use. Methods: Clinical outcomes of all patients undergoing liver transplantation (LT) with an aorto-hepatic conduit between 2000 and 2016 were included. Recipients were divided into 2 groups: those with a supraceliac (SC) aortic conduit (N = 22) and those with an infrarenal (IR) aortic conduit (N = 82). Results: There was no difference in calculated model for end-stage liver disease score between the 2 groups. The SC group received grafts with a higher mean donor risk index (1.69 versus 1.48; = 0.02). Early allograft dysfunction was 18.2% in the SC group and 29.3% in the IR group ( = 0.30). In the SC group, 10.5% of patients required initiation of postoperative continuous renal replacement therapy compared to 12.1% of patients in the IR group ( = 0.69). No difference in the rate of postoperative acute kidney injury was seen between the 2 groups ( = 0.54). No significant difference in median creatinine at 1 year was seen between the SC (1.2?mg/dL; IQR 1-1.3) and IR (1.2?mg/dL; IQR 0.9-1.5) groups ( = 0.85). At a median follow-up of 5.3 years, thrombosis of the aortic conduit occurred in 0% of patients in the SC group and 6.1% of patients in the IR group ( = 0.24). Graft survival was not significantly different between the 2 groups ( = 0.47). Conclusions: No difference in renal dysfunction as demonstrated by need for post-LT continuous renal replacement therapy, acute kidney injury, or creatinine at 1 year post-LT was seen between SC and IR aortic conduits. A slight trend of higher conduit thrombosis rate was seen with IR compared to SC aortic conduits; however, this did not reach statistical significance. Both SC and IR aortic conduits represent reasonable options when the native hepatic artery is unsuitable for use.
Journal Title: Transplantation direct
Publisher: Unknown  
Date Published: 2019
LUC Authors
  1. David Lee
    7 Lee
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