Anatomic variations in right liver living donors.
BACKGROUND
Anatomic knowledge is crucial in right liver living donor transplantation.


METHODS
We reviewed radiologic and surgical findings in right liver donors. Arterial and portal anatomy was assessed in 96 donors, biliary anatomy in 77, and hepatic venous anatomy in 65.


RESULTS
Portal vein (PV): 86.4% had classic anatomy; 6.3% had a trifurcated PV; 7.3% had a right anterior PV taken off the left PV. Hepatic artery (HA): 70.8% had classic anatomy; 12.5% had a left HA arising from the left gastric artery; 13.5% had a right HA arising from the superior mesenteric artery; 2.1% had a double replaced left HA and right HA; and in 1.0% the common HA arose from the superior mesenteric artery. Biliary tree: 55.8% had normal anatomy; 14.3% had a trifurcated biliary anatomy; in 5.2% the right anterior bile duct and in 15.6% the right posterior bile duct opened into the left bile duct; in 2.6% the right anterior and in 6.5% the right posterior ducts opened into the common bile duct. Hepatic veins: S5 and S8 accessory hepatic veins had incidences of 43% and 49%, respectively. The incidence of S6 or S7 short hepatic vein was 38%.


CONCLUSIONS
Anatomic variations are common but do not contraindicate donation; surgeons should be prepared to recognize and manage them.
Varotti
Giovanni
G
Recanati/Miller Transplantation Institute, Mount Sinai Hospital, One Gustave L. Levy Place, New York, NY 10029, USA.
Gondolesi
Gabriel E
GE
Goldman
Jeffrey
J
Wayne
Michael
M
Florman
Sander S
SS
Schwartz
Myron E
ME
Miller
Charles M
CM
Sukru
Emre
E
D000328:Adult; D017734:Bile Ducts, Extrahepatic / Q000033:anatomy & histology; D005260:Female; D006499:Hepatic Artery / Q000033:anatomy & histology; D006503:Hepatic Veins / Q000033:anatomy & histology; D006801:Humans; D008099:Liver / Q000033:anatomy & histology* / Q000098:blood supply; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000033:anatomy & histology; D012189:Retrospective Studies; D019737:Transplants