Efficacy of anterior segment drainage reconstruction in right-lobe liver grafts from living donors

Background. The efficacy of additional venous reconstruction in the anterior segment has not been fully investigated for graft congestion in right-lobe liver grafts. Methods. Posttransplant graft venous congestion in the anterior segment was evaluated using magnetic resonance imaging in right-lobe living-donor liver transplantation. Additional venous reconstruction was categorized into two types: reconstruction of tributaries from segment 5 or 8 (n = 11) and reconstruction of the middle hepatic vein (MHV) (n=9). Forty-five grafts only with right-sided hepatic vein(s) including the right hepatic vein served as controls. Results. No significant difference in congestion score of the anterior segment was observed between grafts with V5/8 and standard grafts 1 month after transplantation despite the patency of reconstruction. Only grafts with the MHV showed no congestion (P < 0.01). Conclusions. Drainage reconstruction of tributaries from the anterior segment produces only suboptimal benefits when evaluated radiologically. The addition of the main trunk of the MHV with its surrounding communication has the best effect on the congestion of the anterior segment.