The Use of the "Flange Joint" Anastomotic Technique for Hepatic Artery Reconstruction in Liver Transplantation

Objectives: A successful liver transplantation requires hepatic artery inflow reconstitution. In living donor liver transplantation, there are additional challenges in the form of a short and small-caliber donor vessel stump, exacerbating the challenges of microsurgery. Meanwhile, in deceased donor liver transplantation, vessel diameter mismatch remains a potential challenge since the liver graft is procured with a long segment of the celiac axis with branches of differing calibers. Other challenges include the poor condition of the recipient vessels due to previous trans-arterial chemoembolization or radiofrequency ablation. We present an illustrated report of our anastomosis technique utilizing a "flange-joint" to increase the luminal diameter of the recipient vessel while minimizing the risk of vessel wall separation.