The significance of arterial vascular supply of segment IV in liver transplantations from living donors

The significance of arterial vascular supply of segment IV in liver transplantations from living donors. Purpose: Postoperative CT's in living liver donors were analysed retrospectively to examine whether atrophies of segment IV occur after procurement depending on arterial vascular supply. Patients and methods: Postoperative CT's from 19 living donors were retrospectively analysed. DSA of the upper abdomen had been performed on all donors prior to donation. Results: The preoperative DSA images demonstrated an arterial vascular supply of segment IV from the right hepatic artery in 10/19 cases, from the left hepatic artery in 7/19 cases and from both, left and right hepatic artery, in 2/19 cases. Atrophies were seen in 3/7 patients in which segment IV was perfused via left hepatic artery, in further two patients with perfusion from the right hepatic artery or from both sides respectively Clinically only one patient presented with an abscess. Conclusions: The patterns of vascular supply to segment IV seen in our patients differ from those published by Couinaud. Since only 3/7 patients with an arterial supply from the left hepatic artery developed a segmental atrophy, we conclude that there must be additional, radiologically not identifiable portal venous branches or collaterals from the right portal vein that maintain perfusion of segment IV.