الفهرس 
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Abstract
Hepatic artery reconstruction is the most important procedure for liver transplantation, and complications associated with this vascular reconstruction, such as hepatic artery thrombosis or stenosis, may have a significant influence on the recipients’ prognosis (Marubashi et al., 2013).
Hepatic artery thrombosis (HAT) is the most severe vascular complication with an incidence ranging from 2 to 9% in adults. Its occurrence after LT increases postoperative morbidity and contribute to subsequent primary graft dysfunction, ischemic biliary complications and long-term graft loss (Herrero et al., 2017).
Hepatic artery stenosis (HAS) is an infrequent complication of liver transplant; if left untreated; it can lead to hepatic artery thrombosis with high risk of biliary necrosis and graft loss (Molvar et al., 2019).
The purpose of this retrospective study is to evaluate whether the selection of the recipient’s right versus left hepatic artery for hepatic artery reconstruction as the recipient’s inflow artery will influence the chance of Hepatic artery thrombosis or stenosis after LDLT.
This is a retrospective study analyzed and evaluated the hospital records of all patients who underwent LDLT at Ain Shams University specialized Hospital (ASCOT) from January 2010 to January 2020.
Records of all 390 patients were reviewed and DROP out of 101 patients was performed according to the exclusion criteria.
The study included All adult patients of both sexes eligible for LDLT and excluded any patients with preoperative portal vein thrombosis, left lobe LDLT or Paediatric liver transplantation.
Preoperative laboratory and ultrasound were analysed as well as post-operative U/S and Laboratory workup for the 1st 3 months. In addition to that, in case of arterial complications, the management done for this arterial complication as well as the outcome of the management was analysed.
The obtained data were then collected, tabulated and statistically analysed.
The study showed that the right hepatic artery was used in 79.5 % of cases while the left hepatic artery was used in 20.1% of cases in the whole study population. Incidence of arterial complications was 11.1% in the whole study population.
Analysis of the arterial complications showed that hepatic artery thrombosis constituted 65.6% while hepatic artery stenosis constituted 37.5 %.
Regarding the intervention done, 50 % of cases were managed conservatively, 34.4% were re-explored, arterial stenting was performed in 18.7 % of cases and re-transplantation was done in 3.1%. After the intervention 6.3% of cases developed Bile leak. 9.4% developed Biliary stricture and mortality was 40.6 % which was statistical significant difference when compared to the uncomplicated group.
With further analysis of the arterial complication group and distribution according to the usage of right or left hepatic artery as an inflow artery, when using the right hepatic artery as an inflow artery there was a statistical significant increase in hepatic artery thrombosis as it constituted (82 %) of arterial complications occurred when using the right hepatic artery compared to (30 %) when the left hepatic artery was used as an inflow artery. On the other hand, there was a statistical significant increase in hepatic artery stenosis as it constituted (70 %) of arterial complications when using the left hepatic artery as an inflow artery compared to (22.7 %) of arterial complications occurred when using the right hepatic artery.
In conclusion, the HAT rates were generally higher following LDLT using the right hepatic artery as the recipient’s inflow artery. On the other hand, hepatic artery stenosis incidence was higher when using the Left hepatic artery as the recipient’s inflow artery.