Right liver graft without middle hepatic vein reconstruction from a living donor

A case of adult-to-adult, living-donor liver transplantation using a right liver graft is described. In the donor operation, when the middle hepatic vein (MHV) was clamped after hepatic transection, reversed flow was detected in MHV tributaries by intraoperative color Doppler ultrasonography. Regurgitated flow in the clamped inferior right hepatic vein was also demonstrated. Portal flow remained hepatopetal during the procedure. Based on these ultrasonographic findings, neither the MHV tributaries nor the inferior right hepatic vein was reconstructed.