Anatomy of the right liver lobe: a surgical analysis in 124 consecutive living donors

Bageacu S, Abdelaal A, Ficarelli S, ElMeteini M, Boillot O. Anatomy of the right liver lobe: a surgical analysis in 124 consecutive living donors.
Clin Transplant 2011: 25: E447–E454. © 2011 John Wiley & Sons A/S. Abstract: Background: Understanding anatomic variations of the right lobe is fundamental in adult to adult living donor liver transplantation. Methods: We analysed anatomy in 124 right liver (RL) donors. Results: Portal vein: normal anatomy was found in 85.5% donors. In 14.5% the main right portal vein (PV) was absent. Hepatic artery: single arterial inflow of the RL was identified in 96% of donors. In 4% two arterial stumps were found. Bile duct: classic anatomy was identified in 50.8% of donors; 9.7% had a trifurcation of the common bile duct; in 7.2% the right anterior and in 15.3% the right posterior bile duct opened into the left bile duct; one segmental bile duct opened directly into the common bile duct in 12.1% and two segmental bile ducts in 4.8%. Hepatic veins (HV): in 74.3% the right HV was the single outflow; in 24.2% significant accessory HV (>5 mm) were preserved, in 2.4% the middle HV was harvested. We found that patients with PV variations had high incidence of multiple bile ducts (88.9%) while patients with single right PV had lower incidence (42.4%) (p = 0.00026). Conclusion: While anatomic variations in the RL donor were common, no contraindication to RL harvesting was noted in this study.