# Liver Transplantation Using an Iliac Artery Graft for a Patient With a Celiac Artery Aneurysm: A Case Report

## TL;DR

A patient with a celiac artery aneurysm successfully underwent liver transplantation using an iliac artery graft, avoiding complications and ensuring proper blood flow.

## Contribution

This case report demonstrates the safe use of an iliac artery conduit for liver transplantation in patients with celiac artery aneurysms.

## Key findings

- The iliac artery conduit was successfully anastomosed to the supraceliac aorta and common hepatic artery during liver transplantation.
- Postoperative imaging confirmed patency of the graft without vascular complications.
- The approach is proposed as a safe and promising alternative for patients with celiac artery aneurysms.

## Abstract

Celiac artery aneurysm is a rare entity among the visceral artery aneurysms, with a high risk of rupture, resulting in high mortality. Arterial complications, such as thrombosis, dissection, and hemorrhage, are among the most serious complications after liver transplantation (LT), which can lead to abscess formation, ischemic cholangiopathy, and hepatic ischemia and necrosis. Therefore, an adequate inflow of the hepatic artery is crucial to avoid any occlusion after LT. When a normal arterial anastomosis is not appropriate, the use of an artery conduit is an important option for graft vascularization.

Herein, we present a patient who underwent LT using an iliac artery conduit due to a celiac artery aneurysm. A 53-year-old man with a history of alcoholic cirrhosis presented to the Emergency Department of our institution with abdominal pain and jaundice. He was diagnosed with alcoholic cirrhosis and admitted to our hospital the same day. A preoperative contrast-enhanced computed tomography (CT) scan revealed a celiac artery aneurysm with dissection. Therefore, hepatic artery reconstruction with an iliac artery conduit was planned. Twenty days after the initial visit, he underwent transplantation. At the time of surgery, the supraceliac aorta was exposed after his native liver was explanted. After cavo-cavostomy and portal vein anastomosis were performed, the iliac artery conduit was anastomosed with the supraceliac aorta and the implanted common hepatic artery, with a running suture. On postoperative day 2, the patency of the iliac artery conduit was confirmed by contrast-enhanced CT scan. His postoperative course was uneventful, without any vascular complications. For patients with a celiac artery aneurysm, the use of an iliac artery conduit in LT can be performed safely. This approach may become a promising alternative for future treatment.