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

Clin Transplant. 2011 Jul-Aug;25(4):E447-54. doi: 10.1111/j.1399-0012.2011.01466.x. Epub 2011 Apr 26.

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.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Bile Ducts / anatomy & histology
  • Bile Ducts / surgery*
  • Cohort Studies
  • Female
  • Hepatectomy
  • Hepatic Artery / anatomy & histology
  • Hepatic Artery / surgery*
  • Hepatic Veins / anatomy & histology
  • Hepatic Veins / surgery*
  • Humans
  • Liver / anatomy & histology*
  • Liver / blood supply
  • Liver / surgery*
  • Liver Transplantation / methods*
  • Living Donors*
  • Male
  • Middle Aged
  • Portal Vein / anatomy & histology
  • Portal Vein / surgery*
  • Prognosis
  • Retrospective Studies
  • Young Adult