An Arterial Conduit is Not a Risk Factor for Survival Following Orthotopic Liver Transplantation: An Analysis of 20 Years of Liver Transplantation in Innsbruck

作者：Denecke Christian^*; Weiss Sascha; Biebl Matthias; Fritz Josef; Dziodzio Tomasz; Aigner Felix; Sucher Robert; Brandl Andreas; Boesmueller Claudia; Pratschke Johann; Oellinger Robert

来源：Annals of Transplantation, 2016, 21: 321-328.

DOI：10.12659/AOT.896659

• Anastomosis, Surgical
• Liver Transplantation
• Patient Outcome Assessment

Background: In adult liver transplantation, arterial conduits have been associated with increased risk for vascular complications and inferior outcome.
Material/Methods: Complication rates and outcomes of adult patients undergoing liver transplantation in our center between 1990 and 2012 were analyzed retrospectively. Characteristics, transplantation-related factors, and survival rates of patients with conduit grafts (n=43) were compared to patients with a standard arterial anastomosis (n=904) by univariate and multivariate analysis.
Results: Patients in the conduit group were younger but had a significantly higher proportion of high-urgency and re-transplantations. While patient survival was comparable between the groups, graft survival was inferior for patients with a conduit (1-year, 5-year, and 10-year survival, control vs. conduit group: 87.3%, 78.8% and 71.5% vs. 72.4%, 63.8%, and 41.8%, respectively, p=0.008). In univariate analysis, an arterial conduit was associated with more arterial and biliary complications. However, an arterial conduit was not an independent risk factor for graft or patient survival in a Cox regression analysis.
Conclusions: An arterial conduit is associated with more vascular complications, yet a conduit per se does not influence graft survival. The inferior outcome may reflect the complex situation of the sicker liver transplant patients needing a non-standard arterial anastomosis.

• 出版日期2016-5-24