Abstract:
Background: Anomalous course of hepatic arteries is common and present important considerations during liver transplantation (LT), particularly in patients with hepatic malignancies. Understanding their impact is essential for surgical planning and optimizing outcomes.
Methods: A systematic review was conducted following PRISMA guidelines. Literature was searched across four databases. Search terms included MeSH and keywords such as “Hepatic Artery,” “Anatomical Variation,” “Liver Transplantation,” “Malignancy,” and “Surgical Outcomes.” Studies were included if they involved adult patients undergoing LT for malignant indications and reported the presence and impact of hepatic artery anomalies on surgical or oncologic outcomes. Non-transplant studies, cadavers, paediatric populations, and studies lacking relevant outcome data were excluded.
Results: Eligible articles were included after screening by title, abstract and full-text review. Data extraction and risk of bias assessments were independently conducted using validated tools. Replaced right and left hepatic arteries were the most frequently encountered variants. While these anomalies increased intraoperative complexity and vascular complication risk, they did not adversely affect graft or overall survival. Preoperative imaging and surgical planning were critical to mitigating associated risks.
Conclusion: Hepatic artery anomalies are not contraindications to liver transplantation for malignancy but require careful consideration to ensure favourable outcomes. Recognition and management of these variations are essential components of transplant oncology.
