Interventional management of graft hepatic artery dissection in a donor right hepatectomy: a case report

Abstract

Graft hepatic artery dissection (GHAD) is a rare but serious complication in liver transplantation, often leading to graft loss and retransplantation. Treatment typically involves re-establishing arterial flow through primary repair and reanastomosis. We present the case of an 11-year-old female with a history of biliary atresia admitted for decompensation. During back-table preparation following a donor right hepatectomy, GHAD was identified. The dissected segment was excised, but the dissection extended toward the graft. The intima was sutured circumferentially, and anastomosis was completed. Intraoperative ultrasound revealed inadequate arterial flow, prompting perioperative angiography, which identified a narrowed segment at the anastomosis site. An expendable coronary stent was deployed, significantly improving arterial flow. The patient required no further interventions and was discharged on postoperative day 25, with aspirin as the sole antiplatelet agent. This case highlights the effectiveness of stent placement in managing GHAD through an endovascular approach.