Hepatic artery reconstruction using polytetrafluoroethylene (PTFE) as an ilio-hepatic conduit in liver transplantation

A sufficient and patent arterial flow is crucial in orthotopic liver transplantation to a greater extent among living than deceased donors as vessels are oftentimes shorter and smaller in caliber. Noteworthy complications such as thrombosis may bring about graft necrosis, liver abscess, ischemic cholangiopathy or graft failure, leading to increased mortality. In deceased donor transplantation, meticulous vessel preparation at the back-table and the availability of longer segments of artery with an aortic patch allow surgeons to maximize the artery at hand during implantation. The usual method of arterial reconstruction is an end-to-end anastomosis between the donor and recipient hepatic artery. Various alternative options are available when the recipient hepatic artery is not suitable for anastomosis, namely, more proximal arteries, interposition grafts, stored cadaveric vessels or rarely, prosthetic vessel conduits. We present a case of a 40-year-old male who underwent deceased donor liver transplantation wherein a hepatic arterial reconstruction was performed by fashioning a polytetrafluoroethylene (PTFE) graft between the recipient external iliac artery and donor celiac artery (ilio-hepatic conduit). Patient remains asymptomatic with good graft function and patent hepatic artery after 1 year of follow-up.