Comparison of microsurgery method and non-microsurgery methods in hepatic artery anastomosis in living donor liver transplantation

Due to the small artery diameter of the graft liver lobes taken from the living donor, the anostomosis requires special microsurgery techniques and equipment. The purpose of this study was to separate the LDLT (living donour liver transplant) HA (hepatic artery) anastomoses made in our hospital into two groups as "with non-microsurgical technique" and "with microsurgical technique" and to determine the efficacy of microsurgery technique to improve both graft and patient surveys by retrospectively evaluating both groups according to laboratory findings and mortality rates. Microsurgical microvascular anastomosis technique was used in all patients in the experimental group. In case of difference in the diameter of the recipient and donor vessels, a microvascular anastomosis technique called Omer Özkan's open guide suture technique was used as the microsurgical method. In our study, HA anastomosed patients with non-microsurgical method (control group) between 2014-2015 and microsurgical method (experimental group) between 2015-2017 were compared with laboratory values and surveys retrospectively. The mortality rates in the experimental group (10%) were significantly lower than those in the control group (25%) (p <0,05). HAT (hepatic artery thrombosis) developed in 2 patients in the control group; no HAT was developed in any patient in the experimental group. There was no significant difference between the two groups in the comparison of LFT. The success of liver transplantation depends on adequate blood flow to the graft and the success of HA anaostomosis. It is clear that microsurgical techniques are directly related to the success of anastomosis, as it can be ascertained from where the suture is passed and the vessel lumen can be seen more clearly in small diameter arterial anastomoses. It can be said that the mortality rates are higher in the non-microsurgical group and the method applied in the microsurgical group is more successful in terms of mortality. Appropriate microsurgery techniques based on accumulated experience for a safe and reliable arterial anastomosis are indispensable for LDLT.