Abstract Background Vascular complications in liver transplantation are associated with increased postoperative morbidity and mortality. The primary objective of our study was to determine whether postoperative acute rejection in patients undergoing liver transplantation is associated with vascular diameter and anastomotic angle mismatch. Our secondary objective was to evaluate the relationship between the anastomotic angle and hepatic artery and portal vein ratios between donors and recipients, as well as the likelihood of thrombosis in these patients. Materials and Methods Our study involved a retrospective review of 289 adult LTs performed at our center from 2012–2023. Fourteen of these patients were excluded from the study due to the absence of early postoperative computed tomography images in our center's archive, whilst the remaining 275 were included. Results Our evaluation revealed that 80 patients (29.1%) developed biopsy-confirmed acute rejection, and 37 patients (13.5%) experienced hepatic artery thrombosis. Portal vein thrombosis was identified in 43 patients (15.6%). No significant differences in the angles of hepatic artery thrombosis and portal vein thrombosis were observed between patients with and without rejection. Conclusion We believe that diameter discrepancies between the recipient and donor hepatic artery and portal vein, as well as the anastomosis angle, may influence graft vascularity and ultimately lead to rejection in liver transplantation patients. The effects of the anastomosis angle and the significant diameter discrepancy between the hepatic artery and portal vein on rejection should be re-evaluated in larger patient groups at different centers using different surgical approaches.
Yağdıran et al. (Fri,) studied this question.