title: Use of right lobe graft with type IV portal vein accompanied by type IV biliary tree in living donor liver transplantation: report of a case.
abstract: Anatomic variations of the portal vein (PV) and bile duct (BD) are more common on the right lobe as compared with left lobe grafts in living donor liver transplantation (LDLT). We recently experienced a case of LDLT for hepatocellular carcinoma combined with liver cirrhosis secondary to hepatitis B virus and hepatitis C virus infection. The only available donor had right lobe graft with type IV PV associated with type IV BD. The patient underwent relaparotomy for PV stenting due to PV stenosis. Percutaneous transhepatic biliary drainage was done for a stricture at the site of biliary reconstruction. Thereafter, the patient was discharged in good health. Our experience suggests that, the use of right lobe graft with type IV PV accompanied by type IV BD should be the last choice for LDLT, because of its technical difficulty and risks of associated complications.
authors.affiliation: Department of General Surgery, Assiut University Hospital, Assiut, Egypt.
authors.forename: Mahmoud Refaat
authors.initials: MR
authors.lastname: Shehata
authors.affiliation: Department of HBP Surgery and Liver Transplantation, Korea University College of Medicine, Seoul, Korea.
authors.forename: Dong-Sik
authors.initials: DS
authors.lastname: Kim
authors.affiliation: Department of HBP Surgery and Liver Transplantation, Korea University College of Medicine, Seoul, Korea.
authors.forename: Sung-Won
authors.initials: SW
authors.lastname: Jung
authors.affiliation: Department of HBP Surgery and Liver Transplantation, Korea University College of Medicine, Seoul, Korea.
authors.forename: Young-Dong
authors.initials: YD
authors.lastname: Yu
authors.affiliation: Department of HBP Surgery and Liver Transplantation, Korea University College of Medicine, Seoul, Korea.
authors.forename: Sung-Ock
authors.initials: SO
authors.lastname: Suh
keywords: Anastomosis; Postoperative complications; Roux-en-Y; Vascular complication