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Anatomic variations in right liver living donors
Giovanni Varotti1, Gabriel E Gondolesi, Jeffrey Goldman
1Recanati/Miller Transplantation Institute, Mount Sinai Hospital, One Gustave L. Levy Place, New York, NY 10029, USA.
Journal of the American College of Surgeons
|March 31, 2004
Summary
Anatomical variations in liver donors are common, affecting portal veins, hepatic arteries, and biliary trees. These variations do not prevent donation but require surgeon awareness for safe liver transplantation.
Area of Science:
- Hepatobiliary Surgery
- Transplant Surgery
- Surgical Anatomy
Background:
- Accurate anatomical understanding is essential for successful right lobe living donor liver transplantation.
- Variations in vascular and biliary anatomy can pose challenges during donor hepatectomy and recipient transplantation.
Purpose of the Study:
- To investigate the prevalence and types of anatomical variations in right lobe liver donors.
- To provide data that aids surgeons in recognizing and managing these variations.
Main Methods:
- Retrospective review of radiologic and surgical findings in right lobe liver donors.
- Assessment of portal vein, hepatic artery, biliary tree, and hepatic venous anatomy.
Main Results:
- Significant variations were observed in portal vein (13.6%), hepatic artery (29.2%), and biliary tree (44.2%) anatomy.
- High incidences of accessory hepatic veins (S5: 43%, S8: 49%) and short hepatic veins (S6/S7: 38%) were noted.
- While classic anatomy is most frequent, numerous deviations require careful consideration.
Conclusions:
- Anatomical variations are frequent in right lobe liver donors.
- These variations do not preclude donation but necessitate preparedness for recognition and management by surgical teams.
- Detailed pre-operative anatomical assessment is critical for safe living donor liver transplantation.