Sequential portal and arterial revascularization (SPAr) is the most common method of graft reperfusion at
liver transplantation (LT), contemporaneous portal and arterial revascularization (
CPAr) was used to reduce arterial
ischemia to the bile ducts. Aim of this pilot study is to prospectively compare SPAr (group 1 #38) versus
CPAr (group 2 #42) in 80 consecutive LTs. Biliary anastomosis was always duct to duct [T-tube in 21 % of cases (p = 0.83) in both groups].
CPAr had longer
warm ischemia 61 ± 10 versus 39 ± 13 min, p < 0.0001, while SPAr had longer arterial
ischemia 96 ± 39 min (p = 0.0001). No PNF while DGF was encountered in 10 versus 5 % (p = 0.32). One-year graft and patient's survival were respectively 87 versus 93 % and 83 versus 88 % in groups 1 and 2 (p = 0.31 and p = 0.39). At a median follow-up of 19 ± 8 versus 17 ± 8 months (p = 0.24), biliary complications were 28 %, being 39 % in group 1 and 19 % in group 2 (p = 0.04). Anastomotic
stenoses were present in 11 versus 12 % (p = 0.84), biliary leakage in 5 versus 5 % (p = 0.72) and intrahepatic non-anastomotic biliary
strictures in 23 versus 0 % (p = 0.0008) in groups 1 and 2.
CPAr is safe and feasible and reduces the incidence of intrahepatic biliary
strictures by decreasing the duration of arterial
ischemia to the intrahepatic bile ducts.