Variations in the origin of middle hepatic artery: a cadaveric study and implications for living donor liver transplantation

다국어 초록 (Multilingual Abstract)

Living donor liver transplantation has been associated with severe vascular complications like hepatic artery thrombosis, which commonly involves the hepatic segment 4. Most authors have defined the artery to this segment as the middle hepatic artery. The present study was undertaken to characterize the origin of middle hepatic artery and classify the variations observed in cadaveric livers, and also to analyze the significance (if any) of the findings in relation to living donor liver transplantation. The study was conducted on 125 adult livers, without macroscopic abnormalities, retrieved from human cadavers (age, 55−78 years; male, 77; female, 48) obtained from clinical wards. The hepatic arterial system was exposed, the origin of the middle hepatic artery was identified in each liver specimen and the variations observed in its origin were noted across all the specimen. Six types of hepatic arterial configurations were observed based on variations in the origin of middle hepatic artery, taking into consideration the presence of accessory hepatic arteries. It was noted in 19 (15.2%) livers that in the presence of an accessory left hepatic artery, the middle hepatic artery arose as a sub-branch of the right hepatic artery. Presence of the above hepatic arterial configuration in the donor could possibly be associated with an increased risk of intra-operative injury to the middle hepatic artery during right/left lobe living donor liver transplantation and this may subsequently lead to serious post-operative vascular complications like hepatic artery thrombosis.

목차 (Table of Contents)

• Abstract
• Introduction
• Materials and Methods
• Results
• Discussion
• References

참고문헌 (Reference)

1 Satheesha Badagabettu Nayak, "Vascular variations of liver and gallbladder: a case report" 대한해부학회 46 (46): 217-219, 2013

2 Futara G, "Variations of the hepatic and cystic arteries among Ethiopians" 39 : 133-142, 2001

3 Hjortsjo CH, "The topography of the intrahepatic duct systems" 11 : 599-615, 1951

4 Katsume Y, "The statistical report about thirteen anomalous cases on the branches of the celiac trunk" 41 : 266-273, 1978

5 Healey JE Jr, "The intrahepatic distribution of the hepatic artery in man" 20 : 133-148, 1953

6 Daseler EH, "The cystic artery and constituents of the hepatic pedicle: a study of 500 specimens" 85 : 47-63, 1947

7 Onishi H, "Surgical anatomy of the medial segment (S4) of the liver with special reference to bile ducts and vessels" 47 : 143-150, 2000

8 Couinaud C, "Surgical anatomy of the liver revisited: embryology" Couinaud 11-24, 1989

9 Mizumoto R, "Surgical anatomy of the hepatic hilum with special reference to the caudate lobe" 12 : 2-10, 1988

10 Hiatt JR, "Surgical anatomy of the hepatic arteries in 1000 cases" 220 : 50-52, 1994

11 Bismuth H, "Surgical anatomy and anatomical surgery of the liver" 6 : 3-9, 1982

12 Fan ST, "Safety and necessity of including the middle hepatic vein in the right lobe graft in adult-to-adult live donor liver transplantation" 238 : 137-148, 2003

13 Sakai H, "Reliability of hepatic artery configuration in 3D CT angiography compared with conventional angiography: special reference to living-related liver transplant donors" 18 : 499-505, 2005

14 Picquand G, "Recherches sur l’anatomie du troce coeliaque et de ses branches" 19 : 159-201, 1910

15 Michels NA, "Newer anatomy of the liver and its variant blood supply and collateral circulation" 112 : 337-347, 1966

16 Descomps P, "Le tronc coeliaque" G. Steinheil 1910

17 Couinaud C, "Le foie. Etudes anatomiques et chirurgicales" Masson & Cie 146-186, 1954

18 Couinaud C, "Le foie. Etudes anatomiques et chirurgicales" Masson 1957

19 Kamel IR, "Impact of multidetector CT on donor selection and surgical planning before living adult right lobe liver transplantation" 176 : 193-200, 2001

20 O’Rahilly R, "Human embryology and teratology" Wiley-Liss 266-, 1966

21 Saxena R, "Hepatology: A Textbook of Liver Disease" WB Saunders 3-30, 2003

22 Holbert BL, "Hepatic infarction caused by arterial insufficiency: spectrum and evolution of CT findings" 166 : 815-820, 1996

23 Suehiro T, "Hepatic artery reconstruction and biliary stricture formation after living donor adult liver transplantation using the left lobe" 8 : 495-499, 2002

24 Kishi Y, "Hepatic arterial anatomy for right liver procurement from living donors" 10 : 129-133, 2004

25 Yoshimura H, "Evaluation of "M-point" in hepatic artery to identify left medial segment of liver. Angiographic study" 6 : 195-198, 1986

26 Rio-Branco P, "Essai sur l’anatomie et la medecine operatoire du tronc coeliaque et de ses branches, de l’artere hepatique en particulier" G. Steinheil 1912

27 Adachi B, "Das Arteriensystem der Japaner. Vol. 2" Maruzen 18-71, 1928

28 Prakash, "Coeliac trunk and its branches: anatomical variations and clinical implications" 53 : 329-331, 2012

29 Chitra R, "Clinically relevant variations of the coeliac trunk" 51 : 216-219, 2010

30 Wang S, "Characterization of the middle hepatic artery and its relevance to living donor liver transplantation" 16 : 736-741, 2010

31 Aramaki O, "Branch patch reconstruction in living donor liver transplantation: arterialization of grafts with replaced type arteries" 82 : 1541-1543, 2006

32 Michels NA, "Blood supply and anatomy of the upper abdominal organs with a descriptive atlas" Lippincott Co 1955

33 Jin GY, "Anatomical variations of the origin of the segment 4 hepatic artery and their clinical implications" 14 : 1180-1184, 2008

34 Ugurel MS, "Anatomical variations of hepatic arterial system, coeliac trunk and renal arteries: an analysis with multidetector CT angiography" 83 : 661-667, 2010

35 Koops A, "Anatomic variations of the hepatic arteries in 604 selective celiac and superior mesenteric angiographies" 26 : 239-244, 2004

36 Sakamoto Y, "Advantage in using living donors with aberrant hepatic artery for partial liver graft arterialization" 74 : 518-521, 2002

37 Brown RS Jr, "A survey of liver transplantation from living adult donors in the United States" 348 : 818-825, 2003