Double arterial revascularization of a liver graft

A 57-year-old patient with polycystic liver disease exhibited indication for transplantation due to abdominal compartment syndrome. She presented a replaced right hepatic artery originating from the superior mesenteric (Michels type 3) and a common hepatic artery originating from the celiac trunk. In the donor, a left hepatic artery was identified that originated from the left gastric artery and was significant in caliber (Michels type 5). It was necessary to perform a double arterial anastomosis (common hepatic artery of the recipient with the celiac trunk of the donor, and right hepatic artery of the recipient with the splenic artery of the donor) to achieve adequate revascularization of the graft. In the end, a total arterial flow of 146 mL/min was achieved, and the patient’s postoperative progress was favorable.