Arterial vs venous conduits for hepatic artery bypass in pediatric living donor liver transplantation: A retrospective study

doi:10.3748/wjg.121888

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Dec 28, 2026; 32(48): 121888
Published online Dec 28, 2026. doi: 10.3748/wjg.121888

Table 1 Baseline and preoperative characteristic comparisons between two groups, n (%)/mean (95%CI)

Characteristics	GSV conduit group (n = 34)	Arterial conduit group (n = 33)	P value
Donors
Sex, female	14 (41.2)	21 (63.6)	0.066
Age (years)	33.7 (8.9)	30.8 (8.2)	0.236
BMI (kg/m²)	21.6 (2.4)	22.1 (2.5)	0.454
≥ CDC III	0	0	NA
Recipients
Sex, male	19 (55.9)	16 (48.5)	0.544
Age (months)	9.0 (4.0-216.0)	12.0 (4.0-216.0)	0.741
Height (cm)	69.0 (56.0-173.0)	71.0 (57.0-173.0)	0.801
Weight (kg)	8.2 (5.0-71.0)	10.0 (5.0-70.0)	0.665
Causes for transplantation			0.614
Biliary atresia	22 (64.7)	19 (57.6)
Liver cancer	7 (20.6)	6 (18.2)
Others	5 (14.7)	8 (24.2)
PELD/MELD score	12.0 (-10.0 to 23.0)	14.0 (-7.0 to 33.0)	0.090
Graft types			0.392
Left lateral segment	19 (55.9)	15 (45.4)
Reduced left lateral segment	4 (11.8)	3 (9.1)
Extended left lateral segment	3 (8.8)	2 (6.1)
Left lobe	3 (8.8)	5 (15.1)
Right lobe without middle hepatic vein	4 (11.8)	2 (6.1)
Right lobe with middle hepatic vein	1 (2.9)	6 (18.2)
History of TACE	6 (17.6)	1 (3.0)	0.105
Graft weight (g)	240.0 (142.0-860.0)	300.0 (180.0-1500.0)	0.104
GRWR (%)	2.41 (0.63-5.31)	2.68 (0.69-5.24)	0.465

BMI: Body mass index; CDC: Clavien-Dindo classification; GRWR: Graft-to-recipient weight ratio; GSV: Great saphenous vein; MELD: Model for end-stage liver disease; PELD: Pediatric end-stage liver disease; TACE: Transcatheter arterial chemoembolization; NA: Not available.

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Table 2 Characteristic comparisons for hepatic artery bypass between two groups, n (%)

Characteristics	GSV conduit group (n = 34)	Arterial conduit group (n = 33)	P value
Causes for HAB
Small caliber arteries (< 2 mm)	16 (47.1)	17 (51.5)	0.715
Short stumps	12 (35.3)	11 (33.3)	0.866
Multiple hepatic arteries	5 (14.7)	5 (15.2)	1
HA dissection	1 (2.9)	3 (9.1)	0.356
Types of HAB			0.614
Supra-celiac	33 (97.1)	31 (93.9)
Infra-renal	1 (2.9)	2 (6.1)

GSV: Great saphenous vein; HAB: Hepatic artery bypass; HA: Hepatic artery.

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Table 3 Types of donations after citizen’s death-derived arterial grafts in the arterial conduit group, n (%)

Types of arterial conduits	Total (n = 33)	HAT
SpA	11 (33.3)	1
SMA	9 (27.2)	0
GeA	5 (15.1)	0
GLA	2 (6.1)	0
IA	2 (6.1)	0
GDA	2 (6.1)	0
IA + SpA¹	2 (6.1)	0

¹Used for infra-renal aorto-hepatic conduit bypass.

HAT: Hepatic artery thrombosis; SpA: Spleen artery; SMA: Superior mesenteric artery; GeA: Gastroepiploic artery; GLA: Left gastric artery; IA: Iliac artery; GDA: Gastroduodenal artery.

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Table 4 Postoperative complications of donor sites in the great saphenous vein conduit group, n (%)/median (interquartile range)

Complications at GSV donor site	Results
Living liver donor	28 (82.4)
Incision infection	2 (5.9)
Long-standing peripheral edema	6 (17.6)
Length of wound (cm)	6 (4-10)
VSS score	8 (2-15)

GSV: Great saphenous vein; VSS: Vancouver Scar Scale[12].

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Table 5 Perioperative and postoperative outcome comparisons between two groups, n (%)/median (interquartile range)

Characteristics	GSV conduit group (n = 34)	Arterial conduit group (n = 33)	P value
Perioperative
Blood loss (mL)	300 (50-4000)	500 (100-8000)	0.447
Transfusion volume (mL)	438 (0-4300)	675 (0-8000)	0.198
Operation duration (hours)	9.1 (6.0-18.0)	8.5 (6.0-16.0)	0.131
PV-HART (minutes)	75 (34-125)	59 (18-130)	0.088
APT (minutes)	85 (55-154)	84 (52-137)	0.215
CIT (minutes)	213 (80-525)	249 (126-486)	0.268
WIT (minutes)	4 (3-5)	4 (3-6)	0.432
Postoperative
≥ CDC III	18 (52.9)	14 (42.4)	0.389
PVT, n	0	1	0.493
Mean (95%CI)	0	0.030 (-0.031 to 0.092)
PGN, n	6	4	0.386
Mean (95%CI)	0.176 (0.041-0.311)	0.121 (0.004-0.239)
HAT, n	2	1	0.511
Mean (95%CI)	0.059 (-0.025 to 0.142)	0.030 (-0.031 to 0.092)
HA patency time, days, mean (95%CI)	2668 (2444-2892)	3020 (2838-3202)	0.567
Graft loss, n	7	5	0.562
Mean (95%CI)	0.206 (0.063-0.349)	0.152 (0.022-0.281)
Graft survival time, months, mean (95%CI)	73.9 (60.2-87.7)	88.2 (75.5-100.8)	0.689
Death, n	6	4	0.386
Mean (95%CI)	0.176 (0.041-0.311)	0.121 (0.004-0.239)
Overall survival time, months, mean (95%CI)	78.1 (66.2-90.0)	91.3 (79.8-102.8)	0.549
Hospital stays	25.0 (5.0-127.0)	27.0 (2.0-58.0)	0.532
HA patency			0.567
1-day	32 (94.1)	33 (100.0)
7-day	32 (94.1)	32 (97.0)
1-year	32 (94.1)	32 (97.0)

APT: Anhepatic phase time; CDC: Clavien-Dindo classification; CIT: Cold ischemia time; GSV: Great saphenous vein; HA: Hepatic artery; HAT: Hepatic artery thrombosis; PGN: Primary graft nonfunction; PV-HART: Portal vein-hepatic artery reperfusion time; PVT: Portal vein thrombosis; WIT: Warm ischemia time.

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Table 6 Characteristics of recipients with hepatic artery thrombosis

Characteristics	Patient ID
Characteristics	Case 27	Case 41	Case 73
Sex	Female	Male	Female
Age (months)	216	156	202
PELD/MELD score	10	11	10
History of TACE	Yes	No	No
Conduit type	GSV	GSV	SpA
HAT
Postoperative day	1	1	2
Location	GSV	GSV	Recipient HA
Treatment	Thrombolysis	Re-transplant	Thrombectomy
Outcome	Death	Death	Death
Cause of death	Liver failure	Septic shock	Liver failure

GSV: Great saphenous vein; HA: Hepatic artery; HAT: Hepatic artery thrombosis; MELD: Model for end-stage liver disease; PELD: Pediatric end-stage liver disease; SpA: Spleen artery; TACE: Transcatheter arterial chemoembolization.

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Citation: Li B, Wei XZ, Song JL, Lv T, Yang J, Ma YK, Zhao JC, Jiang M, Yang JY, Huang B. Arterial vs venous conduits for hepatic artery bypass in pediatric living donor liver transplantation: A retrospective study. World J Gastroenterol 2026; 32(48): 121888
URL: https://www.wjgnet.com/1007-9327/full/v32/i48/121888.htm
DOI: https://dx.doi.org/10.3748/wjg.121888

Li B, Wei XZ, Song JL, Lv T, Yang J, Ma YK, Zhao JC, Jiang M, Yang JY, Huang B. Arterial vs venous conduits for hepatic artery bypass in pediatric living donor liver transplantation: A retrospective study. World J Gastroenterol 2026; 32(48): 121888 [DOI: 10.3748/wjg.121888]

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