Zhang HZ, Lu JH, Shi ZY, Guo YR, Shao WH, Meng FX, Zhang R, Zhang AH, Xu J. Donor hepatic artery reconstruction based on human embryology: A case report. World J Gastrointest Surg 2023; 15(8): 1825-1830 [PMID: 37701685 DOI: 10.4240/wjgs.v15.i8.1825]
Corresponding Author of This Article
Jun Xu, PhD, Chief Physician, Dean, Department of Hepatopancreatobiliary Surgery, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan 030000, Shanxi Province, China. junxuty@163.com
Research Domain of This Article
Transplantation
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
He-Zhao Zhang, Jun-Hui Lu, Wen-Hao Shao, Fan-Xiu Meng, Faculty of Graduate Studies, Shanxi Medical University, Taiyuan 030000, Shanxi Province, China
Zhi-Yong Shi, Rui Zhang, An-Hong Zhang, Jun Xu, Department of Hepatopancreatobiliary Surgery, First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi Province, China
Ya-Rong Guo, Department of Oncology, First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi Province, China
Author contributions: All authors contributed to the study conception and design; Xu J conducted a strict review of the article and made a critical review of the content; Zhang HZ and Lu JH were responsible for the design of the subject and the writing of the article; Zhang R, Shi ZY, and Zhang AH were responsible for the implementation of the operation; Guo YR was responsible for the literature retrieval; Meng FX and Shao WH were responsible for the collection and interpretation of data; The first draft of the manuscript was written by Zhang HZ and all authors commented on previous versions of the manuscript; All authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the relatives of patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun Xu, PhD, Chief Physician, Dean, Department of Hepatopancreatobiliary Surgery, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan 030000, Shanxi Province, China. junxuty@163.com
Received: May 2, 2023 Peer-review started: May 2, 2023 First decision: June 16, 2023 Revised: June 20, 2023 Accepted: July 11, 2023 Article in press: July 11, 2023 Published online: August 27, 2023 Processing time: 114 Days and 18.5 Hours
Abstract
BACKGROUND
Embryonic hepatic artery anatomy simplifies its identification during liver transplantation. Injuries to the donor hepatic artery can cause complications in this process. The hepatic artery's complex anatomy in adults makes this step challenging; however, during embryonic development, the artery and its branches have a simpler relationship. By restoring the embryonic hepatic artery anatomy, surgeons can reduce the risk of damage and increase the procedure's success rate. This approach can lead to improved patient outcomes and lower complication rates.
CASE SUMMARY
In this study, we report a case of donor liver preparation using a donor hepatic artery preparation based on human embryology. During the preparation of the hepatic artery, we restored the anatomy of the celiac trunk, superior mesenteric artery, and their branches to the state of the embryo at 5 wk. This allowed us to dissect the variant hepatic artery from the superior mesenteric artery and left gastric artery during the operation. After implanting the donor liver into the recipient, we observed normal blood flow in the donor hepatic artery, main hepatic artery, and variant hepatic artery, without any leakage.
CONCLUSION
Donor hepatic artery preparation based on human embryology can help reduce the incidence of donor hepatic artery injuries during liver transplantation.
Core Tip: The repair of the donor hepatic artery is a very important step in liver transplantation. In the liver with abnormal arterial anatomy, the incidence of hepatic artery injury is very high. We invented a method of donor hepatic artery repair based on human embryology, which is a method of restoring the artery to the embryonic anatomy, greatly reducing the damage probability of the mutated hepatic artery.
