title: Portal venous reconstruction in a living liver donor with an anomalous hepatic arterial and portal venous anatomy.
abstract: Hepatic arterial and portal venous anomalies in living liver donors are not uncommon. Modified surgical techniques may be required in such circumstances, although the safety of the living donor must always be given top priority. We describe here a successful portal venous reconstruction in a living donor with an anomalous hepatic arterial and portal venous anatomy in which the right anterior and posterior hepatic arteries encircled the main portal vein. Although such an anomaly of hepatic vessels was not frequently encountered, we should be able to alter the surgical strategy to deal with it. This case illustrates the importance of preoperative hepatic artery and portal venous evaluation in all living donors to identify the feasibility of modifying vessel anastomoses in living donors, as well as recipients, before living donor liver transplantation.
authors.affiliation: Department of Surgery and Clinical Oncology, Osaka University, Graduate School of Medicine, Suita, Osaka 565-0871, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Marubashi
authors.forename: Keizo
authors.initials: K
authors.lastname: Dono
authors.forename: Masato
authors.initials: M
authors.lastname: Sakon
authors.forename: Kunihito
authors.initials: K
authors.lastname: Gotoh
authors.forename: Hidenori
authors.initials: H
authors.lastname: Takahashi
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Masaru
authors.initials: M
authors.lastname: Kubota
authors.forename: Shinji
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Miyamoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
authors.forename: Shoji
authors.initials: S
authors.lastname: Nakamori
authors.forename: Koji
authors.initials: K
authors.lastname: Umeshita
authors.forename: Morito
authors.initials: M
authors.lastname: Monden
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D000792:Angiography; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006499:Hepatic Artery / Q000002:abnormalities*; D006801:Humans; D017114:Liver Failure, Acute / Q000175:diagnosis / Q000601:surgery; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000379:methods; D019520:Living Donors; D008297:Male; D011169:Portal Vein / Q000002:abnormalities* / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D018570:Risk Assessment; D012720:Severity of Illness Index; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods